Functional recovery after open talar neck fracture with foot dislocation: A case report

We report a Gustilo-Anderson type IIIA open talar neck fracture (Hawkins type II) with medial foot dislocation after a fall from a ladder. Treatment consisted of single-stage surgical management including meticulous irrigation and debridement, anatomical reduction with screw fixation, combined with systemic antibiotics, local vancomycin application, plaster cast immobilization, and adjunctive hyperbaric oxygen therapy. Fracture healing proceeded without major complications, and screw removal was performed at 1½ years due to local irritation. At final follow-up, 3½ years after injury, the patient was pain-free in daily life and able to run up to five kilometers. Functional outcome was good, with an AOFAS (American Orthopaedic Foot & Ankle Society) hindfoot score of 87/100 and an FAAM (Foot and Ankle Ability Measure) activities of daily living score of 75/84 (89%). The patient remained active in sports but had limitations in squatting, jumping, and stop-and-go movements, reflected in the FAAM sports score of 17/32 (53%). This case report suggests that functional recovery can be achieved in open, dislocated talar neck fractures.