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Preliminary fixation

Medial side
The medial talar neck is often somewhat comminuted and can be reduced by using image intensification as a guide. For fixation, one should use a fully-threaded cortex screw in a position fashion. A lag screw would displace and shorten the medial side of the talar neck upon tightening.
This medial K-wire is often best placed through the medial portion of the talar head articular cartilage allowing for countersinking of a future screw.