PURPOSE: To evaluate the clinical results and develope guidelines for surgical treatment of talus fracture. MATERIALS AND METHODS: Among the 60 cases that were treated during March 1990 to November 2000, 34 cases were treated operatively and followed up for more than one year( range: 1 4.4 years ). They were analyzed retrospectively with questionnaire directly or by telephone interview, radiograms and medical records. Clinical results were evaluated by Hawkins 'scoring system. RESULTS: 25 out of 34 cases showed satisfactory results. Unisatisfactory results were seen in cases that we couldn 't achieve anatomical reduction due to severe communition, and also in case of delayed treatment due to associated trauma and soft tissue injury. Six out of 8 cases that showed no Hawkins 'sign developed avascular necrosis. However, satisfactory results were achieved through conservative treatment. CONCLUSION: Satisfactory results could be achieved through early anatomical reduction and rigid internal fixation followed by aggressive rehabilitation. There was no differences in clinical results either by the surgical approach or method of internal fixation. Avascular necrosis was not essentially related to the clinical results.