The anterior approach for the fixation of displaced talar neck fractures--a cadaveric study

Talar neck fractures are rare and are associated with high complication rates. Adequate surgical exposure is essential in the operative management of these challenging injuries. The anterior approach is an alternative to the more commonly described and utilized anterolateral and anteromedial approaches.

The main objective was to compare the surface area of talus visible and quality of exposure via the anterior approach, with the anteromedial and anterolateral approaches.

An anterior approach was performed on five fresh frozen cadaveric specimens. The surface area of talus visible was measured using an Immersion Digital Microscribe and analyzed with the Rhinoceros 3D graphics package. Standard anterolateral and anteromedial approaches were performed in the same specimens and areas visible measured using the same method.

The talar surface area visible using the anterior approach is significantly greater than that visible using the anterolateral approach or anteromedial, without and with medial malleolar osteotomy, as well as combination approaches.

The anterior approach offers excellent visualization in the fixation of displaced talar neck fractures. Greater talar surface area is visible using this approach compared to traditional approaches.