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Updated: Jan 28, 2026

The Generation of Closed Femoral Fractures in Mice: A Model to Study Bone Healing
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Rethinking Avascular Necrosis After Displaced Talus Fractures and Dislocations.

Abigail Frazer1, Silvio Ndoja1, Veronica Grad1

  • 1Schulich School of Medicine and Dentistry, Western University, London, ON, Canada ; and.

Journal of Orthopaedic Trauma
|January 27, 2026
PubMed
Summary
This summary is machine-generated.

Avascular necrosis (AVN) of the talus is common after fractures, but typically does not impact surgical outcomes. Increased age and more incisions correlate with AVN development in talar fracture patients.

Keywords:
dislocationfracturepostoperative outcomestalar avascular necrosis

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Area of Science:

  • Orthopedic Surgery
  • Trauma Care
  • Radiology

Background:

  • Avascular necrosis (AVN) of the talus is a potential complication following talar fractures and dislocations.
  • Predicting talar vitality and its impact on long-term outcomes is crucial for patient management.

Purpose of the Study:

  • To examine the link between AVN of the talus and postoperative results.
  • To evaluate the effectiveness of the Hawkins sign in predicting talar vitality after injury.

Main Methods:

  • Retrospective cohort study at a Level I Trauma center.
  • Included 79 patients with talus injuries (AO/OTA 81-A, B, C) treated between 2007-2017.
  • Analyzed factors like fracture type, surgery timing, reduction quality, Hawkins sign, and outcomes including AVN, collapse, union, arthritis, and secondary reconstructive surgery (SRS).

Main Results:

  • 38% of patients developed AVN; 25% required SRS.
  • AVN was not a significant predictor of SRS, as most AVN cases showed minimal talar dome collapse (<25%).
  • Increased age at surgery and more incisions were associated with AVN development, while early surgery (<24hrs) and anatomic reduction were not.

Conclusions:

  • Radiographic AVN is frequent after talus injuries but often asymptomatic and does not necessitate further surgery.
  • The Hawkins sign's predictive utility for long-term outcomes requires further investigation.
  • Age and surgical approach (number of incisions) are key factors influencing AVN development.