To retrospectively review our current clinical experience with a more upgraded treatment algorithm of the talar neck fracture dislocation.

We evaluated the clinical results of treatment of fifty-three talar neck fractures dislocations for average of 50A months (type 1, 10 fractures; type 2, 26; type 3, 13; type 4, 2; total dislocation, 2). Principally anterolateral approach was used for accurate reduction and firm fixation without damaging the deltoid arterial circulation, which is usually intact in fracture dislo cation.

The overall clinical results were satisfactory in these patients (excellent, 36%; good, 36%; fair, 24%; failure 4%). Avascular necrosis of the talar body occurred in 23.5 percent (12/51) of the talar neck fractures (type 2, 15.4%; type3, 53.8%; type 4, 50%) and 50 percent (1/2) of total dislocations of the talar body. The traumatic osteoarthritis in the subtalar, ankle and talonavicular joints was the most frequent complication (41.5%).

This study revealed relatively better results than previous reports and supports that early anatomical reduction and rigid internal fixation using anterolateral approach and lag screws followed by prompt aftercare could obtain promising good clinical results.