Diagnosis and treatment of the fracture of posterior medial tubercle of talus / 中华创伤骨科杂志

ABSTRACT

Objective To explore the diagnosis and treatment of the fracture of posterior medial tubercle of the talus (PMTT). Methods From June 1993 to January 2002, eighteen patients were definitely diagnosed by CT scan as fractures of PMTT, but three of them had been misdiagnosed at their first visit. Of the 14 patients of them whose subtalar joint was involved, open reduction and internal fixation (ORIF) was adopted in eight, plaster cast fixation in five, and conservative management in one who had rejected any surgical procedures. Of the other four cases, plaster cast fixation of six weeks was applied in three, and excision of fracture fragments was performed in one. Results The mean follow-up was 41.7 months. Evaluation was done according to AOFAS (American Orthopedic Foot & Ankle Society) system. Satisfactory outcome was achieved in one of the first misdiagnosed patients after excision of fracture fragments. Of the others who received operative treatment, excellent result was achieved in seven cases, good in six cases and fair in three cases. The result for the one who refused surgery was poor. Conclusions The fracture of PMTT should be definitely diagnosed by CT. It should be treated operatively by means of internal fixation with half-threaded Titanium screws. Satisfactory outcome can be achieved by excision of fracture fragments for patients who were misdiagnosed at first.