[Fractures of the talus]

Peripheral fractures of the talus, such as fractures of the posterior and lateral process, need no special therapy. Larger fragments with dislocation require open reduction and screw fixation. Small flake fractures with stability of the joint can be removed arthroscopically, but larger fractures should be repositioned with K-wires, small screws. Ethipin or fibrin sealant. Dislocated fractures of the head of the talus should be reduced and fixed by screws or K-wires. Fractures of the neck of the talus with anteromedial or lateral dislocation can be treated by closed reduction and external fixation, irreducible fractures by open reduction and screw fixation. Fractures of the neck and body of the talus with dorsal dislocation or subluxation in the talonavicular joint require osteotomy of the internal malleolus, open reduction and screw fixation. Comminuted and open fractures of the body of the talus are treated by minimal osteosynthesis with K-wires or external fixation. In necrosis of the talus, revascularization using iliac crest bone with vascular pedicle seems to be successful. In arthrosis cases, triple arthrodesis is the best solution.