Treatment of talar neck fractures / 中华创伤杂志

ABSTRACT

Objective To study the methods treating talar neck fractures. Methods From Oc-tober 1988 to June 2004, 66 patients with talar neck fractures were treated with different methods. Accord-ing to modified Hawkins classification, there were 14 patients with type Ⅰ fractures treated with plaster exter-nal fixation, 34 with type Ⅱ treated with manipulative reduction plus plaster external fixation, 16 with type Ⅲ treated with open reduction and internal fixation or joint fusion and 2 with type Ⅳ treated with open re-duction and internal fixation or joint fusion. There were four patients with old fractures. Results All pa-tients were followed up for mean 6.28 years and clinical outcomes evaluated according to Hawkins scoring system, which showed that 19 patients (29%) were graded excellent (including 13 type Ⅰ fractures, 5 type Ⅰ and 1 type Ⅲ), 17 good (including 1 type Ⅰ fracture, 12 type Ⅱ and 4 type Ⅲ), 18 fair (including 11 type Ⅱ fractures, 6 type Ⅲ and 1 type Ⅳ) and 12 poor (including 6 type Ⅱ, 5 type Ⅲ and 1 type Ⅳ). There occurred osteonecresis in 25 patients (38%), traumatic arthritis of ankle joint in 20 (30%) and that of subtalar joint in 26 (39%). Conclusions For type Ⅰ and Ⅱ fractures, plaster external fixation should be the choice of treatment. While open reduction and internal fixation should be done for type Ⅲ talar neck fractures and joint fusion for type Ⅳ and old fractures.