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Orthop Traumatol Surg Res ; 98(4 Suppl): S48-55, 2012 Jun.
Article in English | MEDLINE | ID: mdl-22621831

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.


Subject(s)
Ankle Injuries/surgery , Fracture Fixation, Internal/methods , Fractures, Bone/surgery , Talus/injuries , Talus/surgery , Adolescent , Adult , Aged , Ankle Injuries/diagnostic imaging , Female , Fractures, Bone/diagnostic imaging , France/epidemiology , Humans , Internal Fixators , Male , Middle Aged , Patient Satisfaction , Postoperative Complications/epidemiology , Radiography , Recovery of Function , Retrospective Studies , Talus/diagnostic imaging , Treatment Outcome
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