Fractures of the neck of the talus

Lorentzen, Jørgen; Christensen, S. Bach; Krogsoe, O; Sneppen, O

doi:10.3109/17453677708985121

Cited by 92 publications

(42 citation statements)

References 7 publications

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“…In contrast, the talar neck is a place of decreased resistance to injury compared with the talar body or head as a result of a weaker cortical shell. This may explain its involvement in almost 50% of all talar fractures [29,33]. Overall, although fractures of the talus account for fewer than 1% of all bony fractures [27] and 3% to 6% of all foot fractures [1], they constitute serious injuries [3].…”

Section: Introductionmentioning

confidence: 99%

Bone Microarchitecture of the Talus Changes With Aging

Krause

Rupprecht

Mumme

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Fractures of the talus in the elderly are rare and usually result from high-impact injuries, suggesting only minor age-related bone structure changes. However, total ankle replacement failures with age often result from talar subsidence, suggesting age-related bone loss in the talus. Despite a number of histological analyses of talar microarchitecture, the effects of age and sex on talar microarchitecture changes remain poorly defined.Questions/purposes The aim of this study was to analyze changes or differences in the trabecular microarchitecture of the talus with regard to (1) age and (2) sex. Methods Sixty human tali were harvested from 30 patients at autopsy of three different age groups (20-40, 41-60, 61-80 years). The specimens were analyzed by radiography, micro-CT, and histological analysis. Given that there was no difference between the left and right talus, static histomorphometric parameters were assessed in three regions of interest of the right talus only (body, neck, head; n = 30). Results The talar body, neck, and head were affected differently by age-related changes. The greatest loss of bone volume with age was seen in the talar body (estimate: À0.239; 95% confidence interval [CI], À0.365 to À0.114; p \ 0.001). In the talar neck (estimate: À0.165; 95% CI, À0.307 to À0.023; p = 0.025), bone loss was only moderate and primarily was the result of reduction in trabecular thickness (estimate: À1.288; 95% CI, À2.449 to À0.127; p = 0.031) instead of number (estimate: À0.001; 95% CI, À0.005 to À0.003; p = 0.593). Bone structure changes were independent of sex. Conclusions Age-related bone structure changes predominantly occur in the talar body, which poses a potential risk factor for total ankle replacement loosening. The moderate changes in the talar neck might explain the persistent low incidence of talar neck fractures with age.

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Section: Introductionmentioning

confidence: 99%

Bone Microarchitecture of the Talus Changes With Aging

Krause

Rupprecht

Mumme

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…26 of them had talar neck fractures, and we were able to reexamine 22 of this group. Four patients were lost to followup.…”

Section: Introductionmentioning

confidence: 89%

Surgical Treatment of Talar Neck Fractures

Tyllianakis

Karageorgos

Papadopoulos

et al. 2004

European Journal of Trauma

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Background: Consideration of gravity of talar neck fractures and evaluation of the treatment results. Patients and Methods: 22 patients suffering from talar neck fractures were retrospectively reviewed. There were ten type A, six type B, three type C, and three type D fractures according to the Hawkins classification modified by Canale & Kelly. All patients underwent open reduction and internal fixation. Results: Excellent clinical results were observed in 45.4%, good in 27.2%, fair in 18.1%, and poor in 9.1% of the patients according to the Iowa Ankle Evaluation score. Two patients developed avascular necrosis (AVN) with body collapse, and tibiotalar fusion was required. Furthermore, five patients developed symptomatic subtalar arthritis but did not require subtalar fusion. Conclusion: Accurate early open reduction is considered the treatment of choice for such types of fractures. AVN is associated with late management, while subtalar arthritis does not necessarily lead to subtalar fusion.

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“…1 A 10% incidence of calcaneal fractures has also been reported in conjunction with talar neck fractures. 7 All impending open or open injuries should be treated urgently as the soft tissue envelope is of paramount importance. Following stabilization of the patient and soft tissue healing, the preferred treatment for ipsilateral fractures of the talar and calcaneal should be open reduction and internal fixation, wherever possible, for all displaced fractures.…”

Section: Discussionmentioning

confidence: 99%

Ipsilateral Type IV Closed Talus and Calcaneal Fractures: A Case Report and Review of Literature

Bachhal¹,

Bhagwat²,

Bali³

2013

Journal of Postgraduate Medicine, Education and Research

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Talar and calcaneal fractures are commonly associated with other musculoskeletal injuries and systemic trauma. Both injuries in isolation have a guarded clinical outcome, and are associated with numerous complications whether treated operatively or nonoperatively. Few studies, however, have reported cases with ipsilateral closed talus and calcaneal fractures. We report one such rare case presenting with closed ipsilateral type IV talar neck fracture and type IV communited intra-articular calcaneal fracture as a result of high energy trauma. Unfortunately the patient had a concurrent vascular injury at the proximal tibia level which ultimately necessitated amputation. Through our report we highlight the universally poor results in such cases and discuss the management options if encountered with such a rare pattern of injury.

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Fractures of the neck of the talus

Cited by 92 publications

References 7 publications

Bone Microarchitecture of the Talus Changes With Aging

Bone Microarchitecture of the Talus Changes With Aging

Surgical Treatment of Talar Neck Fractures

Ipsilateral Type IV Closed Talus and Calcaneal Fractures: A Case Report and Review of Literature

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