Journal List > J Korean Orthop Assoc > v.27(1) > 1114419

Kim, Rhee, Kim, Kim, Han, and Kim: The Fracture of the Talar neck The Significances of hawkins' Sign


The fracture of talar neck is the commonest major injury of this bone and it is generally regarded as a serious traumatic lesion of the ankle. A clinical evaluation of 19 patients with fractures of the talar neck has been made since 1986 and followed them more than 18 months for each. The following results were obtained; 1. There are 15 men and their average age was 25.9. Six out of total 19 cases were children and open fractures in three patients each. Common cause of fracture was traffic accident(11/19,73%) and falls from height(5/19,26%), and hyperdorsiflexion injury are common mechanism of fracture(18/19,94.7%). 2. According to the classification by Hawkins, five of the fractures were type I, ten in type II and four in type III. 3. Hawkins' sign was identified in 13 patients from 6 to 16 weeks after fracture, and avascular necrosis developed in only one case. Conversely, 6 fractures did not show a Hawkins' sign and avascular necrosis in five of them was found. 4. Hawkins' sign of subcortical radiolucency was helpful in ascertaining the vascularity after talar neck fracture, and was found in 68% of the fractures (in 80% of type I fractures, in 60% of the type II, and 50% of type III). 5. Avascular necrosis was occurred in 38% of the fractures (in one of five type I fractrues, in three of the type II, and in three of four type III). 6. Those patients without avascular necrosis in long-term follow up had a good clinical result, and five of seven patients with established avascular necrosis followed for an average of 2 years, had also a satisfactory clinical results. Conclusively, the Hawkins' sign was very accurate radiologic findings to detect the vascularity of talus after fracture, but the avascular necrosis of talus and the clinical symptoms are not correlated in long-term follow up.

Similar articles