Fractures of the talar neck

Functional and radiological evaluation

Abstract

Objective: To make a functional and radiological analysis; to describe complications and or evaluate the need of further procedures in a series of patients with talar neck fractures treated with open reduction and internal fixation. Methods: Eight patients were examined - 5 men and 3 women, average-age 32- with talar neck fractures treated with open reduction and osteosynthesis through an anteromedial and anterolateral approach combined with malleolar osteotomy in two patients. They were classified according to Hawkins in: type II (5 patients), type III (2 patients) y type IV (1 patient). Three of them had exposed fractures of Gustilo, type I. When entering, they were examined by computed axial tomography, and radiography. After an average follow-up of 32 months, they were evaluated radiographically and clinically using AOFAS (Ankle-Hindfoot Scale) score. Complications and/or need for further procedures were also considered. Results: Radiographic evaluation showed 3 patientes with subtalar asymptomatic arthrosis - 2 grade I and 1 grade II. Further surgical procedures were not needed. There was no evidence of cases with avascular necrosis, non-union, malunion or infections. A post- surgical AOFAS score of 84.25 was obtained. Excellent: 3 patients, Good: 20 patients and Fair: 3 patients. Conclusion: 62,5% of the patients in our series showed excellent to good results. There were no complications or need for further procedures. Among the limitations of this research, it can be mentioned: the small sample, the type of work (retrospective) and the level of the evidence (IV).