Open reduction and internal fixation for concomitant talar neck, talar body, and medial malleolar fractures: a case...

Fractures of the talus are rare and generally associated with severe trauma. The mechanism of injury is usually forced dorsiflexion or a fall from a height. Severe talar fractures pose a challenge for surgeons as they are often associated with complications such as avascular necrosis, collapse, malunion, secondary osteoarthritis and pain. This has led some institutions to advocate primary arthrodesis for these injuries. We report an unusual complex fracture of the talus that was successfully managed with open reduction and internal fixation. By restoring a near-normal range of motion and function to a fit, young male, the severely limiting effects of arthrodesis were avoided or at least delayed. We use this case to highlight that primary arthrodesis should only be reserved for cases that fail to respond to open reduction and internal fixation or deteriorate to the point where it is the only reasonable and justifiable alternative.