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Talar neck fracture
Other Resources UpToDate PubMed

Talar neck fracture

Contributors: Adwin Denasty MD, Benedict F. DiGiovanni MD, FAOA, FAAOS
Other Resources UpToDate PubMed


Emergent Care / Stabilization:
All cases of displaced talar neck fractures will require urgent closed reduction in the ED with a short leg splint.

Causes / typical injury mechanism: Talar neck fractures typically occur after forced hyper-dorsiflexion with axial load, usually caused by high-energy mechanisms such as a fall from a height, motor vehicle crashes, and airplane crashes.

Classic history and presentation: These injuries usually present with severe pain, swelling, inability to bear weight, and limited range of motion (ROM) of the ankle and subtalar joints.

  • Age – Most commonly seen in patients aged 20-30 years.
  • Sex / gender – More common in men than women.
Risk factors: High-energy trauma.

Pathophysiology: Acute forced hyper-dorsiflexion of the talus against the anterior tibia.

Grade / classification system: Hawkins classification
  • Hawkins I – nondisplaced
  • Hawkins II – subtalar joint subluxation or dislocation
  • Hawkins III – subtalar and tibiotalar joint subluxation or dislocation
  • Hawkins IV – subtalar, tibiotalar, and talonavicular subluxation or dislocation


S92.113B – Displaced fracture of neck of unspecified talus, initial encounter for open fracture
S92.116A – Nondisplaced fracture of neck of unspecified talus, initial encounter for closed fracture

208685009 – Closed fracture talus, neck
208697005 – Open fracture talus, neck

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Last Reviewed:05/08/2023
Last Updated:05/17/2023
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Talar neck fracture
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