Case for small group discussion Talar fracture Case for small group discussion AOTrauma—Foot & Ankle Module 2b: Hindfoot trauma—talar fractures Stefan Rammelt, DE

Case description 15-year-old girl Fell from a horse Presentation after 5 days

Questions Diagnosis? Management? Approaches? Timing?

Intraoperative images Medial approach Lateral approach

2.5-year follow-up

2.5-year follow-up

Take-home messages CT scans are essential for planning approaches/reduction Anatomical reduction of joint facets Beware of lateral process fractures Stable fixation (screws, minifragment plates) Early motion (after soft-tissue consolidation)

References Rammelt et al. Injury. 2009;40:120–135. Rammelt et al. Foot Ankle Clin. 2006;11:61–84, viii. References: Rammelt S, Zwipp H. Talar neck and body fractures. Injury. 2009 Feb;40(2):120–135. Rammelt S, Winkler J, Grass R, et al. Reconstruction after talar fractures. Foot Ankle Clin. 2006 Mar;11(1):61–84, viii.