Abstract
Numerous fixation techniques have been described for the talar neck but there is a lack of consensus on a superior method. We present a reliable observation of the morphology of talar neck fractures and demonstrate how this can be used to justify a pragmatic fixation method. The “anatomic” versus the “surgical” neck can be determined from the routine preoperative imaging. Appreciation of which fracture variant is present guides the fixation strategy as outlined. Our department has adopted this fixation principle over a 5-year period for a consecutive series of 8 talar neck fractures. Over our series we have not observed any loss in reduction or avascular necrosis. We would propose that talar neck fixation should be based on the location of the primary fracture line and the presence of medial comminution.
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