title: The anterior approach for the fixation of displaced talar neck fractures--a cadaveric study.
abstract: BACKGROUND
  Talar neck fractures are rare and are associated with high complication rates. Adequate surgical exposure is essential in the operative management of these challenging injuries. The anterior approach is an alternative to the more commonly described and utilized anterolateral and anteromedial approaches.
  
  
  OBJECTIVE
  The main objective was to compare the surface area of talus visible and quality of exposure via the anterior approach, with the anteromedial and anterolateral approaches.
  
  
  METHODS
  An anterior approach was performed on five fresh frozen cadaveric specimens. The surface area of talus visible was measured using an Immersion Digital Microscribe and analyzed with the Rhinoceros 3D graphics package. Standard anterolateral and anteromedial approaches were performed in the same specimens and areas visible measured using the same method.
  
  
  RESULTS
  The talar surface area visible using the anterior approach is significantly greater than that visible using the anterolateral approach or anteromedial, without and with medial malleolar osteotomy, as well as combination approaches.
  
  
  CONCLUSIONS
  The anterior approach offers excellent visualization in the fixation of displaced talar neck fractures. Greater talar surface area is visible using this approach compared to traditional approaches.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK. Electronic address: 1michael.mullen1@gmail.com.
authors.forename: Michael
authors.initials: M
authors.lastname: Mullen
authors.forename: Anand
authors.initials: A
authors.lastname: Pillai
authors.forename: Quentin A
authors.initials: QA
authors.lastname: Fogg
authors.forename: C Senthil
authors.initials: CS
authors.lastname: Kumar
mesh_terms: D001863:Bone Screws; D002102:Cadaver; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D010027:Osteotomy; D012984:Software; D013628:Talus / Q000293:injuries* / Q000601:surgery*
keywords: Approach; Fracture; Neck; Talar; Talus