Talar head fracture: A case report, systematic review and suggested algorithm of treatment

Abstract

Introduction: Talar head fractures are uncommon. This rarity contributes to the lack of structure and clarity in its management. The purpose of this systematic review is to analyse the published literature on management of these injuries and suggest a treatment plan that was followed in our case.

Methods: A search of Medline, EMBASE, AMED and Google Scholar was performed on 1st September 2014. Any article reporting case(s) of talar head fractures were included and studies of other anatomical types of talar fractures, stress fractures or paediatric cases were excluded. The paucity of data precluded data synthesis and instead a narrative synthesis was performed.

Results: Of 45 studies identified, five publications with seven case reports met the inclusion criteria. One occurred secondary to snowboarding, one wakeboarding, one inversion injury whilst walking and one gymnastic injury. Two patients were managed operatively and two non-surgically with one requiring surgery for a symptomatic mal-union.

Conclusion: Talar head fractures are rare and high quality literature regarding management of these injuries is lacking. A suggested algorithm for treatment is proposed, but further robust studies are required to substantiate this approach.

Keywords: Fractures; Head; Management; Talus.