• Anders Hammarberg, Michael Möller, Olof Wolf, Per Jolbäck, Jonas Sundkvist, and Sebastian Mukka.
• Department of Diagnostics and Intervention (Orthopaedics), Umeå University, Umeå, Sweden.
• Injury. 2024 Nov 1; 55 (11): 111861111861.

BackgroundReports in the literature on talar head fractures are rare and limited to case reports and small case series.Questions/PurposesThis study aimed to describe a national cohort of talar head fractures for fracture characteristics, associated injuries, treatment, and reoperations.MethodsWe reviewed all radiographs of patients enrolled in the SFR between 2011 and 2021 showing talar head fractures (AO/OTA 81-A3). We excluded those with talar head avulsion fractures, misclassified, multiple registrations, or with a privacy notice in their medical records. The cohort was reviewed using medical records and radiographs at a minimum 2-year follow-up.ResultsThe study included 32 patients (33 fractures) ≥18 years of age. The median age was 32 (range 18-65) years, 84 % were men, and the main trauma mechanisms were motor vehicle accidents (28 %) and falls from heights (28 %) and graded as high-energy injuries in 50 % of the cases. 18 (55 %) were displaced and 15 (45 %) had comminuted fractures. 14 talar head fractures (42 %) had multiple injuries to the same foot. 21 patients (66 %) underwent surgical treatment, most commonly with screw fixation. Surgery was performed in 15 of 18 patients with displaced fractures. Four patients were reoperated, one with arthrodesis of the talonavicular joint and three for implant removal. No cases of avascular necrosis were identified.ConclusionsTalar head fractures are rare and occur mainly in men. They are associated with other foot injuries. Most talar head fractures are treated operatively. In this case series, we did not identify any case of avascular necrosis.Levels Of EvidenceIV, retrospective observational cohort study.Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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