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Abstract Fracture talus is rare representing less than 1% of all fractures. It is usually due to high energy trauma as fall from height or road traffic accident. It is frequently associated with other foot and ankle fractures or polytrauma especially fracture spine. Management of polytraumatised patients has the priority. Stabilization of general condition takes the 1st attention. Reduction of dislocated joints is an emergency. Clinical and radiological evaluation of the fracture type, soft tissue covering and neurovascular condition are mandatory. Radiological evaluation by CT is very helpful and gives accurate estimation of the fracture fracture-dislocation pattern, the status of subtalar joint and associated foot and ankle fractures especially calcaneal fractures. According to our study, surgical timing has a little effect on avascular necrosis and infection rate after talar neck fractures. Anatomical fracture reduction is mandatory to avoid arthritis and malunion. It is achieved by dual approach and under the intraoperative fluoroscopic imaging to evaluate the initial fracture reduction and congruency of ankle and subtalar joints. Postoperative rehabilitation program is a very important item and as much important as the operation itself. In this study, the postoperative 1.5 months non-weight bearing physiotherapy had a positive clinical and functional outcomes. Complications are common and subtalar joint arthritis is the most common one. Even in the absence of osteonecrosis and following anatomic fracture reduction and fixation, patients frequently experience chronic pain and stiffness due to posttraumatic arthritis. |