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Primary total talus arthroplasty for Hawkins type IV talar neck fracture dislocation
  1. Joshua Eskew1,
  2. Zachary Reynolds1,
  3. Joshua Jenkins2 and
  4. Michael Sridhar1
  1. 1Orthopedic Surgery, Prisma Health Upstate, Greenville, South Carolina, USA
  2. 2University of South Carolina School of Medicine Greenville Campus, Greenville, South Carolina, USA
  1. Correspondence to Dr Joshua Eskew; joshua.eskew{at}


A woman in her 40s was involved in a motor vehicle collision and sustained a closed Hawkins type IV talar neck fracture dislocation. The injury was treated with reduction, percutaneous pinning and spanning external fixation, followed by definitive treatment with total talus arthroplasty (TTA) 2 months following injury. This is a unique example of definitive management for a severe talar neck fracture dislocation with arthroplasty in the subacute setting. TTA is perhaps a primary option for these injuries at high risk for avascular necrosis, non-union, malunion and post-traumatic arthritis.

  • Orthopaedic and trauma surgery
  • Orthopaedics

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  • Contributors JE, ZR, JJ and MS were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content. JE, ZR, JJ and MS gave final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.