Introduction: Fractures of the talus neck are rare and serious injuries with a high complication rate. The talus is affected in approximately 2% of all lower extremity injuries and 5-7% of foot injuries. Fixation of the talus neck can lead to significant complications, including ankle and subtalar joint stiffness, avascular necrosis (AVN) of the talus body, ankle arthritis, and subsequent subtalar arthritis. This study aimed to evaluate the operative treatment for talus neck fractures.Methods: All adult patients with talus neck fractures admitted to NMCH&RC in Raichur, Karnataka, India, from March 2022 to May 2024 were included in this study. The cohort consisted of 15 patients, comprising 10 males and 5 females. The fractures were classified according to the Hawkins classification and were treated with open reduction and internal fixation using cannulated compression (CC) screws.Results: All patients were prospectively followed postoperatively, undergoing both clinical and radiological evaluations. The results were analyzed, revealing skin complications in 2 patients and a consolidation rate of 60-70%. The final follow-up examination included the determination of the AHS score (ankle-hind foot scale) from the American Orthopaedic Foot and Ankle Society (AOFAS), as well as assessments of range of motion and radiological analysis.Conclusions: Displaced talar neck fractures present a significant therapeutic challenge due to their substantial early and late complications. Even with optimal management, the non-union rate for type III and type IV Hawkins fractures is 85%, and the incidence of avascular necrosis (AVN) of the talus body is 90-95%, primarily due to compromised blood supply from the talar neck. Types II, III, and IV fractures are often associated with talar body dislocation, which exerts excessive pressure on the soft tissues, leading to significant complications. Achieving early anatomical reduction and stable fixation is crucial for a successful outcome.