A 28-year-old man sustains a talar neck fracture after a fall from height, classified as Hawkins Type II. At 8 weeks after fixation, a mortise view of the ankle shows a linear subchondral radiolucent band just beneath the articular surface of the talar dome. This finding indicates:
- A Preserved vascularity and revascularisation of the talus ✓
- B Progressive avascular necrosis of the talar body
- C Early post-traumatic septic arthritis
- D Subchondral collapse from premature weight bearing
Correct answer: A. Preserved vascularity and revascularisation of the talus
Explanation
The Hawkins sign is subchondral atrophy producing a radiolucent band under the talar dome at 6 to 8 weeks. It appears because osteoclastic resorption continues in living subchondral bone, so its presence means blood supply to the talar body is preserved. Its absence raises concern for avascular necrosis, especially in Hawkins Type II and III fractures. Collapse and septic arthritis do not produce this specific lucent line.
Reference: Rockwood and Green's Fractures in Adults, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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