Review Question - QID 7206

Talar neck fractures are uncommon. In children younger than age 6 years, displacement is rare and closed treatment is usually successful in achieving union and avoiding osteonecrosis. In adolescence, however, talar neck fractures should be treated as they are in adults. This fracture is displaced, and there is dislocation of the subtalar joint. The tibiotalar and talonavicular joints remain reduced. In the classification originally created by Hawkins and modified by Canale and Kelly, this would be a Hawkins type II, carrying a 20% to 50% risk of osteonecrosis. The rate of osteonecrosis increases with the Hawkins grade. The presence of talar neck comminution and open talar neck fractures are also risk factors for osteonecrosis after talar neck fracture.