Abstract
Aims: Consideration of gravity of talar neck fractures and evaluation of their treatment results. Methods: From 1992 to 2001 were admitted to our department 26 patients, suffering from talar neck fractures. We were able to reexam 22 patients (17 males and 5 females), with mean age 34,14y. (16 to 64y.). Fourteen pt. (63,6%) were car accident victims. In the rest of them fracture occurred after fall from height more than 3m. There were 8 (36.3%) multi-injured patients. Preoperative diagnostic approach included simple x-rays and CT scan and Hawkins classiþcation was used. All patients underwent surgical treatment. Operative technique included open reduction and internal þxation using screws and/or K-Ws. Postoperatively patients were evaluated with radiological and clinical criteria according to Iowa Ankle Evaluation score. Results: Mean follow up was 58 months (from 12 months to 9 years). Results were excellent in 10 (45,4%), good in 6 (27.2%), fair in 4 (18.1%) and poor in 2 (11%) patients. Two cases developed avascular necrosis (1 type D and 1 type C) followed by body collapse and treated with ankle arthrodesis. Furthermore 1 patient underwent ankle and 6 patients subtalar arthrodesis because of arthritis caused from concomitant fractures. Conclusions: Treatment of talar neck fractures is a challenge because of high rate of complications, because of talusñ shape and vascular anatomy. Anatomic reduction and rigid internal þxation, in combination with immobilization and no weight bearing until restoration of talusñ architecture is achieved, are essential requirements for good result.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
