# Hawkins — Hawkins classification of talar neck fractures

> Classifies talar neck fractures by associated joint dislocation, predicting avascular necrosis risk.

**Situação:** vigente · **Órgão:** Musculoesquelético · **Órgão emissor:** Hawkins / Canale-Kelly · **Versão:** 1970 / 1978 (Canale-Kelly) · **Ano:** 1970

## Procedência e vigência
- Família: léxico
- Tipo de lógica: flat
- Modalidade: XR, CT
- Fonte primária: Alton T, Patton DJ, Gee AO. Classifications in Brief: The Hawkins Classification for Talus Fractures (2015) — https://pmc.ncbi.nlm.nih.gov/articles/PMC4523513/
- Última verificação: 2026-06-26
- Última checagem: 2026-06-26

## Categorias

| Código | Rótulo | Critérios | Conduta | Risco | Localizador | Verificado |
| --- | --- | --- | --- | --- | --- | --- |
| I | 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). | Nondisplaced pattern; the preserved vascular supply allows the lowest-risk treatment of the four types. | Lowest osteonecrosis risk: no cases of avascular necrosis (0%) in Hawkins' original series. | Alton, 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 | 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. | Displaced; warrants reduction and fixation to restore alignment and minimize osteonecrosis risk. | Avascular necrosis in about 42% (10 of 24) in Hawkins' original series; roughly 18% in a modern validation study (Halvorson et al., 2013). | PMC4523513, type II description and AVN rates (42% Hawkins original; 18.4% Halvorson validation). | ✓ |
| III | Type III, subtalar and ankle dislocation | 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. | Highly displaced; urgent reduction and operative fixation, with the highest osteonecrosis risk to counsel. | Avascular necrosis in about 91% (20 of 22) in Hawkins' original series; roughly 45% in the modern validation study. | PMC4523513, type III description and AVN rates (91% Hawkins original; 44.7% Halvorson validation). | ✓ |
| IV | Type IV, plus talonavicular dislocation | 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. | Most severe displacement; operative reduction and fixation of all involved joints. | Avascular necrosis in about 52% (37 of 71) in Canale and Kelly's series; roughly 12% in the modern validation study. | PMC4523513, type IV (Canale-Kelly addition) description and AVN rates (52% Canale-Kelly; 12.1% Halvorson validation). | ✓ |

### Citações por categoria
- **I**: Alton T, Patton DJ, Gee AO. Classifications in Brief: The Hawkins Classification for Talus Fractures (2015) — https://pmc.ncbi.nlm.nih.gov/articles/PMC4523513/ · Alton, 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**: Alton T, Patton DJ, Gee AO. Classifications in Brief: The Hawkins Classification for Talus Fractures (2015) — https://pmc.ncbi.nlm.nih.gov/articles/PMC4523513/ · PMC4523513, type II description and AVN rates (42% Hawkins original; 18.4% Halvorson validation).
- **III**: Alton T, Patton DJ, Gee AO. Classifications in Brief: The Hawkins Classification for Talus Fractures (2015) — https://pmc.ncbi.nlm.nih.gov/articles/PMC4523513/ · PMC4523513, type III description and AVN rates (91% Hawkins original; 44.7% Halvorson validation).
- **IV**: Alton T, Patton DJ, Gee AO. Classifications in Brief: The Hawkins Classification for Talus Fractures (2015) — https://pmc.ncbi.nlm.nih.gov/articles/PMC4523513/ · PMC4523513, type IV (Canale-Kelly addition) description and AVN rates (52% Canale-Kelly; 12.1% Halvorson validation).

## Histórico de versões

| Data | Evento | Detalhe | Situação |
| --- | --- | --- | --- |
| 1978-01-01 | revised | Type IV added by Canale and Kelly. | confirmed |


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> Conteúdo de referência reescrito. Confira a publicação primária vigente. Não é dispositivo médico nem substitui o julgamento clínico. O radiologista responsável pelo laudo permanece o autor e o responsável.

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