Abstract
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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References
Daniels TR, Smith JW (1993) Talar neck fractures. Foot Ankle 14:225–234
Hawkins LG (1970) Fractures of the neck of the talus. J Bone Joint Surg (Am) 52:991–1002
Higgins TF, Baumgaertner MR (1999) Diagnosis and treatment of fractures of the talus: a comprehensive review of the literature. Foot Ankle Int 20:595–605
Thordarson DB (2001) Talar body fractures. Orthop Clin North Am 32:65–77
Szyszkowitz R, Reschauer R, Seggl W (1985) Eighty-five talus fractures treated by ORIF with five to eight years of follow-up study of 69 patients. Clin Orthop Relat Res 199:97–107
Fortin PT, Balazsy JE (2001) Talus fractures: evaluation and treatment. J Am Acad Orthop Surg 9:114–127
Juliano PJ, Dabbah M, Harris TG (2004) Talar neck fractures. Foot Ankle Clin 9:723–736
Inokuchi S, Ogawa K, Usami N (1996) Classification of fractures of the talus: clear differentiation between neck and body fractures. Foot Ankle Int 17:748–750
Canale ST, Kelly FB Jr (1978) Fractures of the neck of the talus. Long-term evaluation of seventy-one cases. J Bone Joint Surg (Am) 60:143–156
Gustilo RB, Mendoza RM, Williams DN (1984) Problems in the management of type III (severe) open fractures: a new classification of type III open fractures. J Trauma 24:742–746
Lindvall E, Haidukewych G, DiPasquale T, Herscovici D Jr, Sanders R (2004) Open reduction and stable fixation of isolated, displaced talar neck and body fractures. J Bone Joint Surg (Am) 86A:2229–2234
Vallier HA, Nork SE, Barei DP, Benirschke SK, Sangeorzan BJ (2004) Talar neck fractures: results and outcomes. J Bone Joint Surg (Am) 86-A:1616–1624
Cyteval C, Sarrabere-Baron M, Cottin A, Benis J, Assi C, Bonnel F (2001) Radioanatomie du pied. In Encyclopédie Médico-Chirurgicale, Elsevier, Paris. 30-400-A-410
Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M (1994) Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int 15:349–353
Elgafy H, Ebraheim NA, Tile M, Stephen D, Kase J (2000) Fractures of the talus: experience of two level 1 trauma centers. Foot Ankle Int 21:1023–1029
Joveniaux P, Ohl X, Harisboure A, Berrichi A, Labatut L, Simon P, Mainard D et al (2009) Distal tibia fractures: management and complications of 101 cases. Int Orthop. doi:10.1007/s00264-009-0832-z
Coltart WD (1952) Aviator's astragalus. J Bone Joint Surg Br 34-B:545–566
Metzger MJ, Levin JS, Clancy JT (1999) Talar neck fractures and rates of avascular necrosis. J Foot Ankle Surg 38:154–162
Peterson L, Romanus B, Dahlberg E (1976) Fracture of the collum tali—an experimental study. J Biomech 9:277–279
Canale ST (1990) Fractures of the neck of the talus. Orthopedics 13:1105–1115
Vallier HA, Nork SE, Benirschke SK, Sangeorzan BJ (2004) Surgical treatment of talar body fractures. J Bone Joint Surg (Am) 86A(Suppl 1):180–192
Garcia-Rey E, Sanz-Hospital FJ, Galdran FJ, Cano-Egea JM, Alcazar LFL (2002) Talar neck fractures: results and complications by type. Foot Ankle Surg 8:203–208
Vallier HA, Nork SE, Benirschke SK, Sangeorzan BJ (2003) Surgical treatment of talar body fractures. J Bone Joint Surg (Am) 85A:1716–1724
Adelaar RS, Madrian JR (2004) Avascular necrosis of the talus. Orthop Clin North Am 35:383–395
Sanders DW, Busam M, Hattwick E, Edwards JR, McAndrew MP, Johnson KD (2004) Functional outcomes following displaced talar neck fractures. J Orthop Trauma 18:265–270
Kienast B, Gille J, Queitsch C, Kaiser MM, Thietje R, Juergens C, Schulz AP (2009) Early weight bearing of calcaneal fractures treated by intraoperative 3D-fluoroscopy and locked-screw plate fixation. Open Orthop J 3:69–74
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Therapeutic study, Level IV
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Ohl, X., Harisboure, A., Hemery, X. et al. Long-term follow-up after surgical treatment of talar fractures. International Orthopaedics (SICOT) 35, 93–99 (2011). https://doi.org/10.1007/s00264-009-0930-y
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DOI: https://doi.org/10.1007/s00264-009-0930-y