Varus hindfoot deformity after talar fracture

Area of Science:

• Orthopedic surgery
• Trauma reconstruction
• Foot and ankle biomechanics

Background:

• Posttraumatic malalignment following talar neck fractures is a common cause of significant pain and functional impairment.
• Failure to achieve anatomic reduction and stable osteosynthesis during initial surgery often leads to long-term complications.

Purpose of the Study:

• To review the management strategies for posttraumatic malalignment after talar neck fractures.
• To outline indications for different reconstructive approaches, emphasizing joint preservation where possible.

Main Methods:

• Literature review of surgical techniques for talar neck fracture malalignment.
• Analysis of secondary reconstruction options including anatomic reduction, arthrodesis, and talar total arthroplasty (TAA).

Main Results:

• Primary anatomic reduction and stable osteosynthesis are key to preventing malalignment.
• Secondary anatomic reconstruction is viable without arthrosis.
• Reorienting arthrodesis addresses joint incongruity and arthritis.
• TAA can be a motion-sparing option with adjacent fusions.

Conclusions:

• Optimal management of talar neck fractures requires precise initial reduction and fixation to prevent malalignment.
• Salvage options for malunion include secondary reconstruction, arthrodesis, or TAA, chosen based on joint condition and patient factors.