Surgical treatment for open dislocation of talus / 中国骨伤

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the clinical effects of surgical treatment for open dislocation of talus.</p><p><b>METHODS</b>From June 2001 to July 2008,the complete data of 11 patients with open dislocations of talus were retrospectively analyzed, including 8 males and 3 females with an average age of 39.5 years (ranged 19 to 52). According to Gustilo typing, type I was in 2 cases, type II in 6 cases, type III A in 2 cases, type III B in 1 case. Five cases were tibial astragaloid joint dislocation in which 3 cases associated with subtalar joint dislocation, 4 cases were subtalar joint dislocation and 2 cases were total dislocation of talus. Among them, 8 dislocations associated with talus fractures. All patients were treated with debridement, open reduction, internal fixation with K-wires or screws and external fixation with plaster or external fixator within 8 hours after injury. External fixations were removed at 6 weeks after operation. Partial weight bearing was permitted only when X-rays indicated bony healing. Clinical effects were evaluated according to AOFAS system and X-ray films during follow-up.</p><p><b>RESULTS</b>The mean time of follow-up was 13.8 months(ranged 10 to 15 months). Eight patients with fractures obtained bone healing in 4-7 months with an average of 4.3 months. No infection of wound or deep tissue was found. At final follow-up, talus necrosis was in 2 cases and traumatic arthritis was in 2 cases. The AOFAS score was 71.3 +/- 8.6, among the total, the pain, function, alignment was respectively (32.4 +/- 7.1), (31.0 +/- 15.7), (7.6 +/- 2.3) scores.</p><p><b>CONCLUSION</b>Complete debridement may avoid infection in treating open dislocation of talus, early reduction and fixation is a key point during treatment.</p>