Descreva o achado como no laudo. A resposta aponta uma das categorias publicadas, com a probabilidade e o trecho que a decide.
Categorias
Reescritas a partir da fonte e citadas
I
1 de 4
Type I, nondisplaced
Minimally displaced talar neck fracture line entering the subtalar joint between the middle and posterior facets, with the talus remaining in anatomic position (no subtalar or ankle dislocation).
CondutaNondisplaced pattern; the preserved vascular supply allows the lowest-risk treatment of the four types.
RiscoLowest osteonecrosis risk: no cases of avascular necrosis (0%) in Hawkins' original series.
verificadoClassifications in Brief: The Hawkins Classification for Talus FracturesAlton, Patton, Gee, 'Classifications in Brief: The Hawkins Classification for Talus Fractures', Clin Orthop Relat Res 2015 (PMC4523513), type descriptions and AVN-rate text: type I no AVN in original series.
II
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Type II, subtalar subluxation/dislocation
Vertical, displaced talar neck fracture with the subtalar joint subluxated or dislocated, but the talus remaining reduced within the ankle (tibiotalar) mortise.
CondutaDisplaced; warrants reduction and fixation to restore alignment and minimize osteonecrosis risk.
RiscoAvascular necrosis in about 42% (10 of 24) in Hawkins' original series; roughly 18% in a modern validation study (Halvorson et al., 2013).
Displaced talar neck fracture as in type II with the addition of dislocation of the ankle (tibiotalar) joint, so the body is dislocated from both the subtalar and ankle joints.
CondutaHighly displaced; urgent reduction and operative fixation, with the highest osteonecrosis risk to counsel.
RiscoAvascular necrosis in about 91% (20 of 22) in Hawkins' original series; roughly 45% in the modern validation study.
Type added by Canale and Kelly: talar neck fracture with dislocation of the body from the ankle or subtalar joint plus additional dislocation or subluxation of the talar head from the talonavicular joint.
CondutaMost severe displacement; operative reduction and fixation of all involved joints.
RiscoAvascular necrosis in about 52% (37 of 71) in Canale and Kelly's series; roughly 12% in the modern validation study.