J Korean Foot Ankle Soc.  2008 Dec;12(2):163-167.

Avascular Necrosis after Operative Treatment for Fracture and Dislocations of the Talar Neck

• Kong IK
• Seo HY
• Lee KB

Abstract

PURPOSE
To evaluate the incidence of avascular necrosis (AVN), prognostic reliability of the Hawkins sign, and clinical outcomes after operative treatment of fracture and dislocations of the talar neck.
MATERIALS AND METHODS
We analysed 16 patients with fracture and dislocations of the talar neck which were treated by open reduction and internal fixation and followed up for more than 2 years. The postoperative radiographs were examined for Hawkins sign and avascular necrosis was confirmed by bone scan. The assessment of clinical results was based on the Hawkins scoring system.
RESULTS
AVN was occurred in 2 of 16 cases (12.5%) only in type III. Hawkins sign was found 11 of 16 cases (68.8%), which included 8 cases in type II, 2 cases in type III and 1 case in type IV. The Hawkins sign was not observed in two cases with AVN. In contrast, only 2 of the 5 cases with a negative Hawkins sign developed AVN. According to Hawkins scoring system, 4 patients (25.0%) was in excellent, 7 patients (43.8%) in good, 4 patients (25.0%) in fair and 1 patient (6.3%) in poor.
CONCLUSION
Incidence of AVN after operative treatment of fracture and dislocations of the talar neck was lower than that of previous reports. Hawkins sign had a high prognostic reliability, but absence of Hawkins' sign should not be considered a totally reliable indicator of development of avascular necrosis.

Keyword

Talar neck; Fracture and dislocations; Hawkins sign; Avascular necrosis

MeSH Terms

Dislocations
Humans
Incidence
Neck
Necrosis