Talar Fracture

  • Gregory R. Waryasz


The talus is a hindfoot bone that articulates with the calcaneus, tibia, fibula, and navicular. The blood supply is from the posterior tibial artery (artery of tarsal canal and deltoid branch of posterior tibial artery), anterior tibial artery, and perforating peroneal artery via the artery of the tarsal sinus. Talar neck fractures account for around 50% of all talus fractures. The Hawkins classification is used to help predict the chance of avascular necrosis after fracture of the talar neck. Hawkins I is a nondisplaced fracture and has a 0–13% AVN risk. Hawkins II is a talar neck fracture with subtalar dislocation (20–50% AVN risk). Hawkins III is a subtalar and tibiotalar dislocation (20–100% AVN risk). Hawkins IV is a subtalar, tibiotalar, and talonavicular dislocation (70–100% AVN risk). Talus neck fractures are usually managed with ORIF. A Hawkins sign is a subchondral lucency that appears on X-ray at 6–8 weeks suggestive of intact vascularity. Other fractures of the talus that occur are talar body, lateral process, posterior process, talar head, and osteochondritis dissecans lesions of the talar dome. A Canale view is the optimal view of the talar neck.


Hawkins sign Canale view Avascular necrosis 

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Gregory R. Waryasz
    • 1
  1. 1.Department of Orthopaedic SurgeryMassachusetts General HospitalBostonUSA

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