- Discussion:
- type I fractures represent non displaced fractures;
- fracture line entering the subtalar joint between the middle and posterior facets;
- only those frxs in which there is no displacement of frx line and no incongruity of subtalar joint are designated as type I frx;
- Radiographic Evaluation:
- consider CT scan if there is any question of displacement;
- Treatment:
- important challenge in this injury is ensuring that anatomic reduction is obtained with no varus rotation;
- most agree that this type of frx should be treated by below knee cast for 8-12 weeks, until clinical & x-ray signs of frx healing occur;
- foot may be placed in slight equinus for proper reduction;
- leg is kept non-wt bearing for 4 weeks, & then wt bearing is allowed in cast for another 8 weeks or until healing is evident by x-rays as evidenced by trabeculations across the fracture site;
- at times, tomograms in the lateral projection will be needed to demonstrate union across the fracture site;
- Complications:
- AVN: 10%
- varus angulation may occur converting fracture to a Type II Talar Frx;
- occurs due to medial comminution;
- the main effect of this is to eliminate subtalar motion