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3Closed reduction

Introduction

Where possible, after the diagnosis of a displaced talar neck fracture, where soft tissue is compromised, a closed reduction must be attempted. This is mandated because soft-tissue and skin compromise may occur if deformity is not reduced. If there is no soft-tissue compromise and the joints are not dislocated, then surgical intervention can be delayed.

A second reason for early closed reduction of talar neck fractures is the importance of the blood supply to the talar neck and body. The complex blood supply is further compromised the longer the displacement, or dislocation, of the fragments is maintained.

However, closed reductions become increasingly difficult with increasing severity of a talar neck fracture. Type 2 talar neck fractures will only have successful closed reduction 30-60% of the time.
The closed reduction does not have to be anatomic. Soft tissues will be protected while further investigation is performed.