Central talar fractures--therapeutic considerations

Talar fractures are rare and often have to be treated in the emergency department by young surgeons. Thus, important literature series, often multicentric, are generally of little interest regarding practical technical considerations. The aim of this paper is to lead the surgeon who has to treat such fractures to reflect on the goals of the treatment and the means to success. There is probably no better example than talar fractures for the application of the four AO basic principles: Anatomical reduction, stable internal fixation, preservation of the blood supply, and early active pain-free motion. After presenting the different approaches to the talus, the blood supply is described precisely, in reference to the surgical exposures. Then the many tools (tricks) to achieve the treatment goals, avoiding dangers and pitfalls, are meticulously described. Some of the goals, pitfalls, and tools are obvious, whereas some are not, but they could be just as important, if not more so.