CHALLENGES IN MANAGING TYPE II HAWKINS TALAR NECK FRACTURES WITH DISPLACED OSTEOSYNTHESIS MATERIAL: INSIGHTS FROM SUCCESSIVE SURGERIES – CASE PRESENTATION

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Article Title:	Challenges in Managing Type II Hawkins Talar Neck Fractures with Displaced Osteosynthesis Material: Insights from Successive Surgeries – Case presentation
Authors:	Deme Paul Alexandru¹, Pop Alexandru Mircea¹
Affiliation:	¹”Vasile Goldis”, Western University of Arad, Faculty of Medicine, Department of Orthopaedics and Traumatology
Abstract:	This article presents a detailed case study of an 18-year-old female who experienced a significant trauma resulting in a Type II Hawkins talar neck fracture after falling from a height. Initial assessments, including a comprehensive CT scan, confirmed the presence of a displaced fracture in the talar neck. Due to the severity and comminutive nature of the fracture, an urgent surgical intervention was deemed necessary. The procedure entailed an open reduction and fixation strategy, utilizing two screws through a minimally invasive surgical approach to stabilize the fracture. In the aftermath of the surgery, the patient’s leg was secured in a non-weight-bearing cast, complemented by a regimen of anticoagulants and pain management medications to mitigate the risk of thrombosis and alleviate pain. Unfortunately, the recovery process was complicated by the migration of the fracture fragments within two months post-operation, highlighting a significant challenge in the postoperative management of such fractures. This unforeseen complication necessitated another surgical intervention. The second procedure focused on the removal of the screws and the application of a more stable fixation method. Nails were inserted through the talonavicular and talocalcaneal joints, aiming to offer a more durable solution to the fracture and minimize the risk of further complications. This case underscores the complexities and potential pitfalls in the surgical management of Type II Hawkins talar neck fractures, particularly with respect to hardware migration. It also emphasizes the importance of vigilant postoperative monitoring and the readiness to adapt surgical strategies in response to evolving clinical scenarios.
Keywords:	talar neck fracture, emergency surgery, hardware migration, minimally invasive surgery, postoperative monitoring
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*Correspondence:	Deme Paul Alexandru, “Vasile Goldiş” Western University Arad, Faculty of Medicine, Department of Orthopedics and Traumatology email:demepaul@gmail.com

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