Osteotomy for malunion of a talar neck fracture: A case report

A malunion of the talar neck after a Hawkins type II fracture/dislocation o f the talar neck occurred in a 34-year-old man after nonoperative treatment . Rigid varus deformity of the forefoot was a source of severe pain and dis ability in this patient, We describe our surgical technique for osteotomy o f the talar neck with insertion of a tricortical iliac crest bone graft to correct the deformity. At follow-up (56 months), the patient had consistent relief of pain and was employed at his preinjury job doing heavy labor. Th e score on the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot S cale improved from 11 points, preoperatively, to 85 points, postoperatively . Radiographs showed maintenance in the position of the osteotomy and no ev idence of avascular necrosis in the talar body. Evidence of arthrosis of th e talonavicular joint was apparent radiographically, but the patient did no t complain of symptoms referable to this area.