Screw fixation of fractures of the neck of the talus using a posterior approach.

Seven fractures of the neck of the talus were internally fixed using a lag screw inserted through the posterior tubercle. This followed closed reduction under fluoroscopic control in five cases with moderate displacement, whereas open reduction was performed in two cases with dislocation of the talar body. The fractures healed in 2 to 3 1/2 months. Clinical results, evaluated between 2 and 7 years after fracture, were excellent in three cases and good in four. Osteonecrosis of the talar body occurred in two cases: in one it was followed by revascularization without bone collapse; in the other it was followed by partial collapse of the body. Although the method described does not give full protection against osteonecrosis, it appears to have definite advantages over conventional methods of treatment.