Talar head and fracture injuries are not easily recognized and can create significant long-term disability when missed. Careful investigation of any injury about the ankle requires both clinical and radiographic examination. A computed tomography scan is extremely helpful in diagnosing and treating talus fractures. Displaced fractures require open reduction of the major joint surfaces and internal fixation. Prolonged non-weight bearing and immobilization is the norm. Despite aggressive management, complications involving avascular necrosis and posttraumatic arthritis to both the subtalar and tibiotalar joints occurs frequently.