Fractures of the talar neck and body result from high-energy, axial loading injuries. Closed reduction should be performed urgently, and open reduction internal fixation (ORIF) is often indicated. Talar neck fractures are generally approached from two incisions facilitating anatomic reduction particularly when dorsomedial comminution is present. Talar body fractures present a particular challenge and may require medial malleolar osteotomy for access. After surgery, patients are kept non-weight-bearing, but early range of motion (ROM) is paramount. Complications such as avascular necrosis (AVN), post-traumatic arthritis, and arthrofibrosis must be managed accordingly.