Single-Lateral-Incision Technique for Talar Neck Fractures—A Viable Option

Abstract

Background: Displaced talar neck fractures are subject to avascular necrosis and degenerative joint disease. A single-lateral-incision approach may avoid damage to the remaining blood supply to the talar body provided by the deltoid artery. The purpose of this paper is to describe the surgical technique for a single approach to talar neck fractures, to evaluate the outcomes in a cohort of patients, and to review the literature on the topic. Method: A retrospective review. Patients were identified at a single medical center and met the following inclusion criteria: closed fracture, type-II talar neck fracture with displacement of the subtalar joint, single lateral operative approach, and radiographic follow-up of at least 6 months. Results: Five patients were identified meeting the inclusion criteria. The mean follow-up was 18 months (12–25). The mean VAS (Visual Analog Score) score at the final follow-up was 1.2 (0–3). Four of five patients returned to running at the final follow-up. The one patient who did not return to running was able to bike and hike. There were no cases of avascular necrosis and no cases of degenerative joint disease. Conclusions: Although a two-incision approach could be considered for all displaced talar neck fractures, there are certain fractures that can be anatomically reduced and stabilized through a single lateral incision which may limit the risk of avascular necrosis.

Keywords

• talar neck fracture
• sinus tarsi approach
• Hawkins Type II
• osteonecrosis