Most common complication, of talus fracture is
Ans. is 'd' Avascular Necrosis Avascular necrosis of the talar body, resulting from interruption of the precarious vascular supply to the talus, is the most dreaded late complication after talar neck fractures. The risk of developing avascular necrosis in a Hawkins type I fracture is only 0% to 15%, since only the blood supply entering through the neck is disrupted. Hawkins type II fractures have a 20% to 50% risk of avascular necrosis, with the artery of the tarsal canal and the dorsal blood supply from the neck being disrupted. Type III and IV fractures have a 69% to 100% risk of avascular necrosis, with all 3 main sources of blood supply damaged. Greater displacement, comminution, and open fractures could increase the likelihood of developing avascular necrosis. Avascular necrosis of the body weakens the talar trochlea, subjecting it to collapse if full weight bearing is allowed in the presence of avascular necrosis. Whether collapse of the talar dome is partial or full, the subsequent degenerative changes lead to pain and disability in both the ankle and subtalar joints, along with shortening of the affected leg. Malunion and Nonunion Talar neck fractures frequently develop malunion and nonunion, leading to decreased range of motion. The incidence of malunion has been reported to be approximately 30%, and the incidence of nonunion is approximately 2.5%. Typical findings of malunion are varus malalignment of the talar neck and deformity of the medial column. Sangeorzan et al stressed that malalignment of only 2 mm results in significant changes in the subtalar contact characteristics that could lead to the progressive development of posttraumatic arthritis. Posttraumatic Arthritis Long-term follow-up studies have shown high rates of posttraumatic arthritis after talar neck fractures. Causes of posttraumatic arthritis may be multifactorial, and may include damage to articular cartilage at the time of injury, progressive cartilage degeneration from fracture malunion, nonunion causing malalignment and incongruence, or osteonecrosis. The incidence of posttraumatic arthritis after talar neck fractures ranges from 50% to 100%, and is a more common finding than osteonecrosis. The arthritis primarily involves the subtalar joint, but may also affect the ankle and talonavicular joints. The subtalar joint is prone to arthritis because the calcaneus slides past the talus during dislocation, causing compressive and shearing forces that may result in injury to the cartilage.Not all cases of posttraumatic arthritis become symptomatic. The development of severe arthrosis causing chronic pain and stiffness may necessitate arthrodesis if conservative treatment is ineffective.
Avascular necrosis
Non union
Osteoarthritis of ankle joint.
Osteoarthritis of subtalar joint.
Injuries of the Foot