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Posted on: February 20 2024

Talar Fractures at ankle Classification system

The talus is a bone that connects the long bones of the leg to the foot. It is part of the ankle joint. 

The Hawkins classification system actually pertains to fractures of the talus bone in the ankle, developed by an Orthopaedic Surgeon Dr Herbert Hawkins.

 The Hawkins classification system is used to classify fractures of the neck of the talus, particularly those resulting from traumatic injuries. It helps guide treatment decisions by assessing the degree of displacement and involvement of the talar neck and thus helps to improve patient outcomes. The system is as follows:

  • Type I: Undisplaced fracture of the talar neck, which is the narrow section of the bone between the body of the talus and ankle joint. These can be managed conservatively with immobilization in a cast or walking boot for several weeks. Weight-bearing may be restricted initially to allow for healing. Follow-up imaging and close monitoring are essential to ensure proper healing.
  • Type II:  Displaced  fracture of the talar neck with partial displacement. Can affect the blood supply to the talus and   often requires surgical intervention. Surgical options may include open reduction and internal fixation (ORIF) with screws, plates, or other hardware.Postoperative rehabilitation typically involves protected weight-bearing and physical therapy to restore ankle function.
  • Type III: This is a fracture of the body of the talus near the talar dome , which is the large, rounded portion of the bone that forms the ankle joint. Usually causes damage to the blood supply to the talus, and can result in avascular necrosis (death of bone tissue) of the talus. displacement of the talar neck. Surgical techniques may include fragment fixation, bone grafting, or joint-sparing procedures. Joint replacement can sometimes be required. Postoperative management and rehabilitation protocols are similar to those for Type II fractures. 
  • Type IV : This fracture typically involves a fracture of the posterior process of the talus, which is the bony projection at the back of the talus bone. Fractures in this area are uncommon and may be associated with significant trauma to the ankle joint. Treatment decisions depend on factors such as the severity of the fracture, degree of displacement, and associated injuries.

Here at Cheltenham Podiatry we have come across the injuries in young soccer players. Diagnostic tools as x ray and CT can help confirm the grading combined with patient presentation and history. A suitable plan will be provided, or in higher graded cases, referral to a specialist foot surgeon.

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