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Talar neck and body fracture outcomes: a multicentre retrospective review

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

Talar neck and body fractures are uncommon injuries that are challenging to manage with high reported complication rates, including post-traumatic arthritis, avascular necrosis, and poor functional outcomes. The aim of this study was to assess the complication rates for patients with talus fractures across three major trauma centres (MTCs) in England.

Methods

A retrospective analysis was performed of prospectively collected trauma databases. Data were collected from three English MTCs. Patients with talar neck and/or body fractures sustained between August 2015 and August 2019 were identified and their clinical course reviewed radiologically and clinically. Isolated process fractures, osteochondral defects and paediatric patients were excluded. Patients were analysed by fracture type and for definitive treatment method with separation into non-operative and operative management groups. Procedure type was identified in the operative group. Superficial infection, deep infection, non-union, avascular necrosis, post-traumatic arthritis and removal of metalwork rates were analysed.

Results

Eighty-five patients with talar neck and/or body fractures were included. Seventy-five patients received operative management, 10 non-operative. The overall AVN rate was 5.9% (five patients), overall post-traumatic arthritis rate was 18.8% (16 patients), deep infection rate 1.2% (one patient), non-union rate 4.7% (four patients). Removal of metalwork rate was 9.4% (eight patients).

Conclusion

Our reported outcomes and complication rates are generally lower than those previously described. This may be a result of improved techniques, a higher frequency of open reduction with direct visualisation or by surgery occurring in centralised specialist centres.

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No patient identifiable information was shared between the sites.

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Funding

The authors did not receive support from any organisation for the submitted work.

Author information

Authors and Affiliations

  1. St George’s University Hospital, London, UK

    Georgina Crate & Alex Trompeter

  2. Royal Sussex County Hospital, Brighton, UK

    Enis Guryel

  3. Oxford University Hospitals NHS Trust, Oxford, UK

    Alexander Martin & Neale J. Marlow

Authors
  1. Georgina Crate
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  2. Alastair Robertson
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  3. Alexander Martin
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  4. Neale J. Marlow
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  5. Enis Guryel
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  6. Alex Trompeter
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Correspondence to Georgina Crate.

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Conflict of interest

Mr Trompeter is paid for services in a research and development capacity for Stryker. He is also paid for services in an educational capacity for Stryker, Smith + Nephew, DePuy Synthes, Orthofix. He receives royalties from JP Medical Publishing; Oxford University Press. He has no conflicts of interest for this work. For the remaining authors none was declared.

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The project was registered at each site as a service evaluation with the respective institutional audit/review board.

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Crate, G., Robertson, A., Martin, A. et al. Talar neck and body fracture outcomes: a multicentre retrospective review. Eur J Orthop Surg Traumatol 33, 99–105 (2023). https://doi.org/10.1007/s00590-021-03161-3

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  • DOI: https://doi.org/10.1007/s00590-021-03161-3

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