![]() Delee gave a five-part classification for talar fractures: type 1, transchondral dome fractures type 2, shear fractures type 3, posterior tubercle fractures type 4, lateral process fractures and type 5, crush fractures. įew classifications systems have been mentioned in literature. Displaced talar neck fractures carry a worse prognosis both in children as well as adults. The most common cause for pediatric talus fractures is road traffic accidents followed by fall from height. Case PresentationĪviator’s astragalus was first described by Anderson resulting from dorsiflexion mechanism of injury. Cast immobilization is sufficient treatment for non-displaced fractures however displaced fractures of the talus require surgical intervention to minimize the risk of trauma-related avascular necrosis (AVN) due to disruption of the vascular supply originating from the talar neck. The most common fracture site is the talar neck, followed by talar body. The pediatric talus can sustain higher forces as compared to adults because the pediatric foot is flexible and has higher elastic resistance than adult bone. Talus fractures are rare injuries in children with an estimated prevalence of 0.008% of all childhood fractures. The peak incidence of fractures in boys occurs at age 16 years (450 per 10,000 per year) and in girls occurs at age 12 years (250 per 10,000 per year). Increased sports participation of children in recent years has been attributed to the increased incidence of fractures. Lastly avoid tourniquets and stable anatomical reduction of fracture is must.Īround 10% to 15% of all childhood injuries are caused by skeletal trauma, with approximately 15% to 30% of these are physeal injuries (phalanx fractures are the most common physeal injury). Such fractures should be reduced as early as possible to reduce the ischemia time thus prevent the chances of osteonecrosis. These types of fractures are rare in children and proper clinical and radiological evaluation is essential. The patient was kept non-weight bearing until fracture united. The patient was discharged in below knee slab which was changed to a non-walking cast at two weeks. His right leg was elevated on pillows and treated with elevation and ice to alleviate the swelling. As the fracture was comminuted and displaced with ankle and subtalar dislocation, operative intervention (open reduction and fixation of talus with crossed K wires) was planned. ![]() ![]() Initial treatment involved a plaster of Paris (POP) back slab with the ankle in a neutral position. His computer tomographic (CT) images demonstrated a Hawkins Type IV talus fracture. On review of the ankle and foot radiographs, he was noted to have a right talar neck fracture with subtalar and ankle dislocation. He had no other injury and no medical or surgical history. A 13-year-old boy was brought to the accident and emergency (A/E) department following a road traffic accident while he was pillion riding a bike. Following the accident, he was unable to bear weight on his right foot and his anterior ankle region was swollen, with no neurological deficit or open wound. ![]() Cast immobilization is sufficient treatment for non-displaced fractures, however displaced fractures of the talus require surgical intervention to minimize the risk of trauma-related avascular necrosis (AVN) due to disruption of the vascular supply originating from the talar neck. Skeletal trauma accounts for 10% to 15% of all childhood injuries, with approximately 15% to 30% of these representing physeal injuries. Talus fractures are rare injuries in children with an estimated prevalence of 0.008% of all childhood fractures. ![]()
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