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A 35-year old male is involved in a fall from height and present with the isolated injury shown in Figures A and B. The body of the talus is extruded medially through a large linear open wound. Along with irrigation and debridement, what is the most appropriate definitive management of this injury?
Reimplantation of the talar body followed by cast immobilization
Reduction of talar body, fracture fixation with smooth Steinman pins, and spanning fixator placement
Talar body allograft with internal fixation to native talar head
Fragment removal, antibiotic spacer placement and external fixation
Reduction of native talar body and ORIF of talar neck fracture
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A 25-year-old man presents one year after undergoing open reduction and internal fixation of the fracture seen in Figure A. Current radiographs demonstrate a united fracture with no evidence of ostenecrosis, subtalar or tibiotalar arthritis. Physical exam is notable for ambulation on the lateral border of the right foot with hindfoot varus, midfoot supination and diminished subtalar motion compared with the contralateral side. Which of the following is an option for reconstruction of this patient's deformity?
Total ankle arthroplasty
Lateral calcaneus closing wedge osteotomy
Calcaneal neck opening wedge osteotomy
Talar neck opening medial wedge osteotomy
Varus malalignment after a talar neck fracture with medial comminution causes a decrease in what motion?
A 30-year-old patient underwent open reduction internal fixation of a talar neck fracture 8 weeks ago. His current radiographs demonstrate a subchondral radiolucency of the dome of the talus. What is the next most appropriate course of action?
Injection of bone cement into the talus to prevent further avascular necrosis
Ankle arthroscopy to address this osteochondral lesion
Continued observation as the vascularity to the talus is intact
A 29-year-old male sustains the isolated lower extremity injury shown in Figure A. During open reduction, what structure must be kept intact in order to protect the remaining blood supply to the talar body?
Anterior talofibular ligament
A 34-year-old female is involved in a motorcycle crash. She sustains a talus fracture with associated dislocation of the subtalar joint and maintained congruence of the tibiotalar and talonavicular joints as shown in Figure A. The fracture has healed and she now has symptomatic impingement of the dorsal surface of the talus on the distal tibia and restriction of ankle dorsiflexion. What is the most likely deformity causing these symptoms?
Combined varus and plantar malunion
Isolated varus malunion
Isolated valgus malunion
Isolated dorsal malunion
Isolated plantar malunion
A 30-year-old male sustains the injury shown in figure A and undergoes successful open reduction and internal fixation. Which of the following radiographic features is a good prognostic factor for this injury?
Talar dome subchondral lucency
Talar dome subchondral sclerosis
Associated medial malleolus fracture
Talar lateral process fracture
A 47-year-old male sustains the closed injury seen in Figures A and B after failing to land a motorcycle jump. A post-reduction radiograph is seen in Figure C. Which of the following is the most appropriate treatment at this time?
Definitive closed treatment
Addition of percutaneous pins
Open reduction and internal fixation
Primary subtalar arthrodesis
A 30-year-old male undergoes successful surgical fixation of a displaced talar neck fracture. Which of the following is the most likely long-term complication even after anatomic reduction and stable fixation is achieved?
Tibiotalar and/or subtalar arthritis
Loss of forefoot supination
HPI - Fell from the stairs.
What is the best treatment option?
HPI - 10 year old patient presents with a painful foot after a fall from height.
The foot is severely swollen and he is unable to bear weight on his affected leg due to significant pain.
What further imaging would you order in this patient?
HPI - Fall from stairs 3 days ago.
What classification is this fracture?