Talar neck fractures: results and complications by type

García-Rey, E.; Sanz-Hospital, F.J.; Galdrán, F.J.; Cano-Egea, J.M.; Alcazar, Luis Fernando Llanos

doi:10.1046/j.1460-9584.2002.00305.x

Cited by 20 publications

(9 citation statements)

References 15 publications

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“…This dual approach is sometimes associated with a medial malleolar osteotomy [7,21]. This technique permits good visualisation of the talus but increases the risk of skin necrosis or infection (10-20% depending on authors) and increases the duration of surgery [21,22]. In our experience, no dual approach was used and fractures were treated through a single approach and sometimes in a percutaneously.…”

Section: Discussionmentioning

confidence: 91%

Long-term follow-up after surgical treatment of talar fractures

Ohl

Harisboure

Hemery

et al. 2009

International Orthopaedics (SICOT)

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Displaced talar neck and body fractures are rare and serious injuries with important outcomes. The aim of our study was to evaluate the long-term outcomes of these fractures after operative treatment in our centre between 1993 and 2005. Displaced talar fractures have a high rate of long-term complications. This was a retrospective study concerning 20 patients with an average follow-up of 7.5 years. The final follow-up examination included determination of the AHS score (ankle-hindfoot scale) from the American Orthopaedic Foot and Ankle Society (AOFAS), range of motion evaluation and radiological analysis. Mean age at the time of trauma was 38.8 years. This study comprised ten talar neck fractures and ten talar body fractures. We always used a single surgical approach and obtained anatomical reduction in 30% of the whole series of both groups. Four early complications were noted in four patients (20%). We noted no skin complications and the rate of consolidation was 100%. Four patients (20%) developed avascular necrosis of the talus, and at final follow-up seven patients (35%) had undergone secondary surgery. Radiographic analysis showed an osteoarthritis rate of 94% and a malunion rate of 59%. The mean AOFAS score was 66.9/100 and range of motion was systematically decreased. Contrary to undisplaced talar fractures, displaced talar fractures are a therapeutic challenge with many early or late complications. The outcome often revealed stiffness and osteoarthritis.

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Section: Discussionmentioning

confidence: 91%

Long-term follow-up after surgical treatment of talar fractures

Ohl

Harisboure

Hemery

et al. 2009

International Orthopaedics (SICOT)

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“…Many authors regard fracture displacement and delayed surgery as the key risk factors and recommend immediate open reduction and internal fixation (ORIF) to decrease the incidence of this dreaded complication [2]. However, the highenergy characteristics and associated injuries often make the diagnosis and immediate ORIF difficult; moreover, associated soft tissue damage significantly increases the early soft tissue complications [3].…”

Section: Introductionmentioning

confidence: 99%

Treatment of displaced talar neck fractures using delayed procedures of plate fixation through dual approaches

Xue

Zhang

Pei

et al. 2013

International Orthopaedics (SICOT)

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Purpose Treatment of talar neck fractures is challenging. Various surgical approaches and fixation methods have been documented. Clinical outcomes are often dissatisfying due to inadequate reduction and fixation with high rates of complications. Obtaining satisfactory clinical outcomes with minimum complications remains a hard task for orthopaedic surgeons. Methods In the period from May 2007 to September 2010, a total of 31 cases with closed displaced talar neck fractures were treated surgically in our department. Injuries were classified according to the Hawkins classification modified by Canale and Kelly. Under general anaesthesia with sufficient muscle relaxation, urgent closed reduction was initiated once the patients were admitted; if the procedure failed, open reduction and provisional stabilisation with Kirschner wires through an anteromedial approach with tibiometatarsal external fixation were performed. When the soft tissue had recovered, definitive fixation was performed with plate and screws through dual approaches. The final follow-up examination included radiological analysis, clinical evaluation and functional outcomes which were carried out according to the Ankle-Hindfoot Scale of the American Orthopaedic Foot and Ankle Society (AOFAS), patient satisfaction and SF-36. Results Twenty-eight patients were followed up for an average of 25 months (range 18-50 months) after the injury. Only two patients had soft tissue complications, and recovery was satisfactory with conservative treatment. All of the fractures healed anatomically without malunion and nonunion, and the average union time was 14 weeks (range 12-24 weeks). Posttraumatic arthritis developed in ten cases, while six patients suffered from avascular necrosis of the talus. Secondary procedures included three cases of subtalar arthrodesis, one case of ankle arthrodesis and one case of total ankle replacement. The mean AOFAS hindfoot score was 78 (range 65-91). According to the SF-36, the average score of the physical component summary was 68 (range 59-81), and the average score of the mental component summary was 74 (range 63-85). Conclusions Talar neck fractures are associated with a high incidence of long-term disability and complications. Urgent reduction of the fracture-dislocation and delayed plate fixation through a dual approach when the soft tissue has recovered may minimise the complications and provide good clinical outcomes.

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“…To achieve better reduction dual anteromedial and anterolateral approach is recommended, which provides better visualization of the talus but having high risk of skin necrosis or infection. 12,13 Fracture neck of talus is highly prone for development of AVN. According to recent studies, the rate of osteonecrosis is variable from 11-50% and which depends on initial degree of fracture displacement.…”

Section: Discussionmentioning

confidence: 99%

Operative Management and Evaluation of Fracture Neck of Talus

Charan¹,

Chaurasia²,

Verma³

2018

jebmh

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BACKGROUND Fractures and dislocations of the talus are a challenging injury. Fractures of the talus are generally thought to be relatively uncommon. However, the talus is the second most commonly fractured tarsal bone. The purpose of this study is to evaluate clinical and radiological outcomes of operatively treated displaced talus fracture. MATERIALS AND METHODS The study is a prospective study of twelve cases of displaced fracture neck of talus evaluated and treated at the department of orthopaedics, Nalanda Medical College and Hospital, Patna from 20 August 2015 to 18 August 2017. RESULTS Reduction was anatomical in six cases (50%), nearly anatomical in 3 cases (25%) and poor in 3 cases (25%). Two patients (16.66%) developed an early superficial infection and required surgical irrigation and debridement and appropriate antibiotic treatment. Using the AOFAS ankle-hindfoot scale, the average functional score was 75.17 points. There was excellent result in four patients, good result in three cases, fair in three and poor result was found in two cases. CONCLUSION Fracture neck of talus (Hawkins type 2 and 3) treated with anatomical reduction and near anatomical reduction had a satisfactory clinical and functional outcome, whereas (Hawkins type 4) had fair to poor outcome with complications like AVN, arthritis and malunion due to poor initial reduction. KEYWORDS Talar neck fractures, Avascular necrosis, AOFAS ankle-hindfoot scale, Hawkins type of fracture.

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Talar neck fractures: results and complications by type

Cited by 20 publications

References 15 publications

Long-term follow-up after surgical treatment of talar fractures

Long-term follow-up after surgical treatment of talar fractures

Treatment of displaced talar neck fractures using delayed procedures of plate fixation through dual approaches

Operative Management and Evaluation of Fracture Neck of Talus

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