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Definitive closed treatment
4%
114/2573
Addition of percutaneous pins
7%
168/2573
Open reduction and internal fixation
86%
2218/2573
Tibiotalocalcaneal arthrodesis
1%
22/2573
Primary subtalar arthrodesis
2%
44/2573
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The clinical presentation and imaging studies are consistent with Hawkins II talar neck fracture, which by definition is a displaced talar neck fracture with subtalar dislocation/subluxation. Despite achieving an adequate reduction initially (shown in Figure C), there is no role for closed treatment of these unstable injuries, and the treatment of choice is open reduction and internal fixation. The referenced article by Bibbo et al describes these injuries: 32% of subtalar joints are irreducible to closed means (half with soft tissue block, half with bony block to reduction), 88% have co-existing injuries of the ipsilateral foot, 89% have radiographic subtalar arthrosis at 5 years (62% symptomatic).
4.0
(21)
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