INTRAARTICULAR FRACTURES OF THE FOOT - TALUS AND LESSER TARSALS

In the absence of historical comparative data for the treatment of tar sal fractures, commonly abided maxims of trauma care are noteworthy. A displaced fracture involving an articular surface or a fracture inter rupting a mechanical axis is treated by open reduction and internal fi xation. Rigid fixation is followed as early as possible with active an d passive mobilization. Unlike long bones, whose motion and fracture p atterns (i.e., segmental, transverse, and oblique) are understood, the tarsal bones are small bones with complex shapes and restricted motio n. As a result, tarsal injuries most often occur with multiple ligamen tous and bony injuries. Articular step-off is difficult to establish r oentgenographically, the blood supply is tenuous, and fixation is larg ely dependent on screws and Kirschner wires. Good outcome can be obtai ned by following principles of internal fixation established in treatm ent of major joint injuries.