Clinical characteristics and outcomes of ipsilateral talar and calcaneal fractures / 中华骨科杂志

ABSTRACT

Objective To investigate the clinical characteristics and outcomes of ipsilateral talar and calcaneal fractures.Methods From April 2003 to July 2011,22 patients with ipsilateral talar and calcaneal fractures were treated in our hospital.There were 20 males and 2 females with an average age of 30.2 years (range,17 to 51 years).The fractures occurred on the left side in 10 patients and on the right side in 12 patients.There were 8 cases of talar neck fracture,including 3 type Ⅰ,3 type Ⅱ and 2 type Ⅲ according to the Hawkins classification; there were 14 cases of talar body fracture,including 6 type Ⅱ,2 type Ⅲ and 6 type V according to the Sneppen classification.There were 13 cases of extra-articular calcaneal fracture and 9 cases of intra-articular fracture.Four patients had open fractures,including 1 type Ⅰ,2 type Ⅱ and 1 type llⅢA according to the GustiloAnderson classification.The average time from injury to surgery was 5.5 hours for patients with open fracture and 11 days for patients with close fracture.Seventeen patients underwent internal fixation and 5 patients underwent non-operative treatment.Results All patients were followed up for 25 to 89 months (average,41.5 months).Skin necrosis of the edges of the incision was found in 2 cases and wound infection in 1 case.No fracture nonunion and loss of reduction were observed in all patients.At final follow-up,the functional results were assessed according to the AOFAS score,and the average AOFAS score was 78.9 (range,53 to 95).The result was excellent in 5 patients,good in 10 and fair in 7,and the overall excellent or good rate was 68.2％.Traumatic arthritis was found in 12 patients who had undergone surgical treatment,including 5 cases in subtalar joint and 7 cases in ankle and subtalar joint.Diaz disease occurred in 1 patient who had undergone non-operative treatment.Conclusion Ipsilateral talar and calcaneal fracture is a complicated injury which has many fracture types.The fractures should be reduced anatomically,and traumatic arthritis is the most common complication.