Are Displaced Talar Neck Fractures Surgical Emergencies? A Survey of Orthopaedic Trauma Experts

Background: Displaced talar neck fractures are relatively rare injuries with potentially serious long-term morbidity. Expedient treatment has long been held as a treatment principle. The purpose of this study was to assess the current state of practice of treating displaced talar neck fractures by recognized orthopaedic trauma experts working at level 1 trauma centers. Methods: A group of expert orthopaedic trauma surgeons were surveyed to determine what they considered “the maximal acceptable time delay from injury to the operating room representing the minimal standard of care at a level 1 trauma center for a displaced talar neck fracture?” Each survey recipient had been selected as a moderator at a national orthopaedic trauma meeting during the past 5 years. Eighty-nine of 109 (82%) responded to the survey. Results: For a displaced talar neck fracture, 60% of respondents stated that treatment after 8 hours is acceptable, with 46% percent of respondents stating that treatment at or after 24 hours is acceptable. Conclusion: These results indicate that most expert orthopedic trauma surgeons do not believe that an immediate operation is necessary to adequately treat a displaced talar neck fracture.