anterolateral incisions are optimal for all talar neck fractures that are treated operatively. These two exposures ensure adequate visualization for reduction and fixation.
Helpful adjuncts in surgery when doing an open reduction include joysticks, external fixator, small distractor, or lamina spreader. A headlamp helps with visualization, and an image intensifier will guide the reduction of this difficult fracture.
If a reduction can not be achieved with the standard two anteromedial and anterolateral approaches, then a
medial malleolar osteotomy is the most common tactic that is used.
An alternative oblique lateral approach is another option.