Abstract

INTRODUCTION
Displaced talar neck and body fractures are rare and challenging for the surgeon. Results are often disappointing due to inadequate reduction or internal fixation and high rates of osteoarthritis and osteonecrosis. Very few published series describe the long-term results after internal fixation of talar factures. One of the goals of the 2011 SOO meeting symposium was to specifically evaluate the long-term results after internal fixation of talar fractures. This study included only central fractures.
MATERIAL AND METHODS
We reviewed the results of 114 central talar fractures that had been treated by internal fixation between 1982 and 2006 in nine hospitals in the Western part of France. The clinical and radiological follow-up was 111 months on average. All the patients with a radiological assessment had at least 5 years of follow-up.
RESULTS
Poor reduction was apparent in 33% of cases. The average Kitaoka score was 70/100, which corresponds to an average functional level. At the last follow-up evaluation, 34% of cases had osteonecrosis and 74% had peritalar osteoarthritis. Secondary fusion was required in 25% of cases with an average follow-up of 24 months.
DISCUSSION
The complication rate for talar fractures was high, mostly due to osteonecrosis and osteoarthritis; these conditions had an impact on the final outcome. The outcome could be improved by better evaluating these fractures with a CT scan, developing dual surgical approaches to best preserve the bone vascular supply and achieve better reduction, and improving the internal fixation hardware, especially the use of plates for comminuted fractures.

Links

Publisher Full Text

Authors

Fournier A, Barba N, Steiger V, Lourdais A, Frin JM, Williams T, Falaise V, Pineau V, Salle de Chou E, Noailles T, Carvalhana G, Ruhlmann F, Huten D

Institution

Service de chirurgie orthopédique, CHU Hôpital Sud, 16, boulevard de Bulgarie, 35200 Rennes cedex 2, France.

Source

Orthopaedics & traumatology, surgery & research : OTSR 98:4 Suppl 2012 Jun pg S48-55

MeSH

Adolescent
Adult
Aged
Ankle Injuries
Female
Fracture Fixation, Internal
Fractures, Bone
France
Humans
Internal Fixators
Male
Middle Aged
Patient Satisfaction
Postoperative Complications
Recovery of Function
Retrospective Studies
Talus
Treatment Outcome

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

22621831