Joy Stick Maneuvre for Closed Reduction and Internal Fixation of Hawkins Type III Talar Neck Fracture

Dr. Siddharth M Shetty; Dr. Vikram Shetty; Dr. Arjun Ballal; Dr. P. Nirmal Babu

Volume : V, Issue : I, January - 2015

Joy Stick Maneuvre for Closed Reduction and Internal Fixation of Hawkins Type III Talar Neck Fracture

Dr. Siddharth M Shetty, Dr. Vikram Shetty, Dr. Arjun Ballal, Dr. P. Nirmal Babu

Abstract :

Talar fractures are rarely encountered and accounts to less than 3% of all foot fractures and 50% of these are fractures of the talar neck. Urgent fracture reduction and fixation is mandatory so is absolute anatomical reduction of the fracture and the dislocation is a must and most often open reduction through a medial malleolar osteotomy will be needed and internal fixation with screw will be performed. These fractures often associated with other major injuries and outcome is often fraught with complication. In this article a simple technique of closed reduction and percutaneous fixation of a type III Hawkins talar neck fracture dislocation is being described, where the swollen skin condition of the ankle and foot did risked wound complications if open reduction was attempted and the dislocation and fracture displacement would not allow any delay in intervention. In this technique Steinmann pins are inserted into the calcaneum and the body of the talus and the dislocation is reduced and the fracture fragments of talus are aligned and percutaneously fixed with a 6.5 mm screw. Talar fracture healing is associated with numerous unfavorable outcomes and achieving a stable and accurate fixation without jeopardizing the skin and vascular structures is paramount in achieving good results, Hence this procedure may be helpful in wriggling out of unpleasant situations.