Primary total talus arthroplasty for Hawkins type IV talar neck fracture dislocation.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Competing interests: None declared. 17. J Clin Med. 2024 Dec 7;13(23):7457. doi: 10.3390/jcm13237457. Allograft Bone Screw in a Comminuted Hawkins III Talar Neck Fracture: Case Report. Huetter K(1), Holweg P(1), Ornig M(1), Labmayr V(1). Author information: (1)Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria. Background: Talar neck fractures are complex injuries that become particularly challenging when accompanied by bone loss or comminution. This case report introduces the use of an allograft bone screw as a novel method for bridging lateral comminution at the talar neck, providing structural support and promoting bone regeneration. Methods: A 20-year-old male sustained a comminuted talar neck fracture with subtalar and tibiotalar dislocation after a bouldering fall. Urgent surgical intervention involved open reduction and internal fixation using a two-incision technique. The medial key fragment was stabilized with two conventional compression screws, revealing a significant lateral bony defect. This was bridged and stabilized with an allogeneic cortical bone screw (Shark Screw®, Surgebright GmbH, Lichtenberg, Austria), supplemented by bone replacement material. Results: At three months, CT confirmed fracture healing, and weight-bearing was initiated. At six months, the AOFAS score was 85/100 and FAAM 69/84, with no significant pain or swelling. By one year, the patient demonstrated full weight-bearing with occasional pain (AOFAS 88/100, FAAM 79/84). At two years, the patient achieved a pain-free range of motion and full activity participation (AOFAS 100/100, FAAM 83/84). Conclusions: The successful application of this technique illustrates the potential of allograft bone screws for stabilizing and bridging defects in talar neck fractures. DOI: 10.3390/jcm13237457 PMCID: PMC11642557