Abstract
Background: Talus is the second largest tarsal bone with unique importance regarding its location and anatomy . It is an osseous link between foot and the leg and has got a pivotal role in overall foot function . It has got three important articulations at tibiotalar , talocalcaneal and talonavicular joint . It is divided into body , neck and posterior facets. Almost 70% surface of talus is covered with articular cartilage . Its blood supply is predominantly extraosseous and is at risk during fractures .
 Objectives : The aim of our study is to observe the long term outcomes after surgical treatment of fracture neck of talus .
 Study design : Prospective cross sectional study .
 Study setting : Department of Orthopedic Surgery Services hospital , Lahore
 Study duration : From Dec 2017 – Feb 2020
 Methodology: After approval from hospital ethical review board , total number of 30 patients with fracture neck of talus , both males ( 20 patients ) and females ( 10 patients ) were included in the study . Each patient underwent X-rays of ankle joint AP , LAT and ankle mortis views .. All these fractures were fixed with 4 mm cannulated screw by using combined anterolateral and anteromedial approach.
 Results: Post-traumatic arthritis was observed in 15 patients (50.0%) out of the 30 patients with 10 (75.0 %) patients at subtalar joint and 5 (25.0 %) patients at ankle joint. Among these 30 patients , 8 (26.7%) patients were having Hawkins type 2 , 14 (46.6%) with Hawkins type 3 and remaining 8 (26.7%) patients with were having Hawkins type 4 fractures. Osteonecrosis was mostly observed in Hawkins type 3 fractures 6 (42.8%) in Hawkins type 3, 2 (25.0%) patients in Hawkins type 2 fractures and 1 (12.5%) patient in Hawkins type 4 fractures. 1 (3.3 %) patient developed non-union and 1 (3.3 %) patient developed delayed union. 4(13.3 %) patients developed the superficial infection which was treated with IV antibiotics and wound irrigation .
 Conclusion: We concluded from our study that familiarity with the complex vascular , bony , surgical anatomy and techniques for rigid fixation of fractures is of utmost importance for fracture neck of talus . Rate of osteonecrosis , arthritis , mal-union and non-union are still high even in the presence of rigid internal fixation of these fractures
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