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Questions and Answers
What is the Hawkins Classification used for?
What is the Hawkins Classification used for?
What is the AVN rate for Hawkins Type 1 fractures?
What is the AVN rate for Hawkins Type 1 fractures?
0-13%
What is the treatment for Hawkins Type 2 fractures?
What is the treatment for Hawkins Type 2 fractures?
Tx with ORIF
What is the AVN risk for Hawkins Type 3 fractures?
What is the AVN risk for Hawkins Type 3 fractures?
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What is unique about Hawkins Type 4 fractures?
What is unique about Hawkins Type 4 fractures?
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What does the Sneppen Classification refer to?
What does the Sneppen Classification refer to?
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What type of fracture is described in Sneppen Group 1?
What type of fracture is described in Sneppen Group 1?
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What is a characteristic of Sneppen Group 3 fractures?
What is a characteristic of Sneppen Group 3 fractures?
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What is the type of fracture referred to as the 'snowboarders fracture'?
What is the type of fracture referred to as the 'snowboarders fracture'?
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What is the AVN risk for Berndt & Harty Type 4 fractures?
What is the AVN risk for Berndt & Harty Type 4 fractures?
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What is a key feature of Berndt & Harty Type 1 fractures?
What is a key feature of Berndt & Harty Type 1 fractures?
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Study Notes
Hawkins Classification (1970)
- Designed for talar neck fractures and predicts prognosis and AVN risk.
Hawkins Type 1
- Non-displaced neck fracture without subluxation.
- AVN risk is between 0-13%.
- Treatment generally involves conservative management: Non-weight bearing (NWB) with a below-knee cast for 6-8 weeks.
Hawkins Type 2
- Characterized by displaced vertical neck fracture with subtalar joint subluxation.
- AVN risk increases to 20-50%.
- Treatment is typically open reduction and internal fixation (ORIF).
Hawkins Type 3
- Involves a displaced vertical fracture with both subtalar joint and ankle joint dislocation.
- Talar body tethered around the deltoid ligament.
- AVN risk ranges from 83-100%.
- Requires ORIF and NWB.
Hawkins Type 4
- Includes a displaced vertical talar fracture along with subluxation or dislocation of the subtalar, ankle, and talonavicular joints.
- Recognized as a rare variant with AVN risk exceeding 91%.
- Complex talar neck fractures that do not fit other classifications may be included here.
Sneppen Classification
- Focuses on fractures of the talar body.
Sneppen Group 1
- Involves transchondral or compression fractures of the talar dome.
Sneppen Group 2
- Defined by coronal, sagittal, or horizontal shear fractures affecting the entire talar body.
Sneppen Group 3
- Characterized by posterior tubercle fractures, which include:
- Cedell fracture: posterior medial tubercle.
- Shepherd's fracture: posterior lateral tubercle.
Sneppen Group 4
- Refers to lateral process fractures known as "snowboarders fractures."
Sneppen Group 5
- Involves crush or comminuted fractures of the talus.
Hawkins Original Classification of Lateral Process Talar Fractures
- Type 1: Simple two-part fracture.
- Type 2: Comminuted fracture.
- Type 3: Chip fracture of the anteroinferior lateral process.
McCrory and Bladin Classification of Lateral Talar Process Fractures
- Type A: Chip (avulsion) fracture.
- Type B: Simple large fragment fracture.
- Type C: Comminuted fracture.
Berndt & Harty Classification for Talar Osteochondral Defect (OCD)
- Type 1: Small area of compression, may not appear on x-ray; treated with 6-12 weeks of below-knee cast immobilization.
- Type 2: Partially detached OCD; 6-12 weeks of below-knee cast immobilization.
- Type 3: Fully detached OCD remaining in the crater; medial cases managed conservatively, lateral cases require surgical treatment.
- Type 4: Displaced OCD, necessitating surgical intervention.
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