Pediatric Talar Neck Fracture in a 4-Year-Old: A Rare Hawkins Type I Injury with Full Recovery

Abstract

Background and objectives: Talar fractures are rare in the pediatric population due to the predominantly cartilaginous composition and pliability of immature bone. Their infrequency and subtle radiographic findings can delay diagnosis. Moreover, these injuries carry a risk of complications such as avascular necrosis (AVN), post-traumatic arthritis, and growth disturbances. This report aims to highlight the presentation, management, and outcome of a pediatric talar neck fracture.

Presentation of the case: A 4-year-old boy presented following a fall from height with pain and swelling in the ankle. Radiographic evaluation revealed a minimally displaced talar neck fracture (Hawkins type I). The patient was treated conservatively with below-knee cast immobilization. Regular follow-up with clinical and radiological assessment showed satisfactory healing without displacement or signs of AVN.

Discussion: Paediatric talar fractures require a high index of suspicion for accurate diagnosis. Hawkins type I fractures are stable and can often be managed non-operatively with immobilization. Early diagnosis and appropriate treatment are critical to minimize complications. Long-term follow-up is essential to monitor for AVN and other sequelae, although the risk is lower in minimally displaced fractures.

Conclusion: Minimally displaced talar neck fractures in children can be effectively managed with conservative treatment, resulting in excellent functional outcomes when diagnosed early and monitored closely.