Avascular necrosis (AVN) of the talus has always been a surgical challenge because the talus is hidden by its anatomic location and has a precarious blood supply. Most cases (75%) of talar AVN are traumatically induced in association with talar body and talar neck fractures.AVN of the talus can be a significant problem because collapse of the talar dome leads to degenerative changes and pain and disability of the ankle and subtalar joints. Although there are many published treatments for posttraumatic AVN of the talus, critical outcome studies are still lacking.