HAWKINS SIGN’S PROGNOSTIC RELIABILITY IN FRACTURES OF TALUS

Abstract

Background

The Talus is a unique bone which has tenuous blood supply and articular cartilage covering 57% of its surface. Fracture of the neck, head or body of talus has increased chances to impair its blood supply resulting in Avascular Necrosis(AVN). AVN of the talus can result in  severe  disability. Many causes exist that can cause talar AVN, with the most common being talus neck fractures. Patients usually present with  ankle pain and limited rom of ankle joint. This study was done to evaluate the prognostic reliability Hawkins sign. The Hawkins sign is a radiolucent band in subchondral region over the dome of talus bone, it emerges as an important early indicator of talus viability at 6 to 8 weeks post fracture which is seen in xray ankle  AP view and rarely appears on lateral view.

Materials And Methods: This is a prospective study conducted at  Saveetha Medical College hospital and included patients treated for displaced talar fractures from January 2023 to December 2023. The study focused on 21 patients who were followed up for 12 months. Reliability of the Hawkins sign and its prognosis was analysed in 21 patients.

Result: 11 patients had positive Hawkins sign, 2 had partially positive and 8 had negative sign with all 8 patients with negative sign developing AVN. Hawkins sign occurred earliest at 6^th week and latest at 9^th week

Conclusion: The Hawkins sign is a valuable prognostic tool for assessing talus vascularity after fractures. A positive Hawkins sign indicates a favourable prognosis regarding the development of AVN. However negative Hawkins sign does not conclusively predict Avascular Necrosis, necessitating further investigation and monitoring in such cases.