Clinical and radiological outcomes of internal fixation of complex talar neck and body fractures with locking plates through a dual approach

Linder, Adrien; Steiger, Vincent; Hubert, Laurent; Rony, Louis

doi:10.1016/j.otsr.2022.103368

Cited by 2 publications

(4 citation statements)

References 35 publications

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“…This compares slightly favorably with recent similar studies, such as Liu et al . 11 and Linder et al ., 12 whose AOFAS functional scores were 79.8 ± 17.3 and 70 ± 18, respectively. We attribute these outcomes to the high‐quality surgical reduction (confirmed by postoperative CT showing 100% anatomical or near‐anatomical reduction) and stable fixation.…”

Section: Discussionmentioning

confidence: 96%

“…Linder et al ., 12 using a bilateral approach combined with locking plates, treated 12 cases of complex fractures involving the talar neck and body, achieving satisfactory results. In contrast to Maceroli et al ., 10 who applied positional screws medial fixation after lateral mini‐plate fixation in 26 cases of comminuted talar neck fractures, our study chose to use cannulated screws medially.…”

Section: Discussionmentioning

confidence: 99%

“…Over the past two decades, there has been a gradual increase in research and publications concerning the application of mini‐plates in the treatment of talarfractures. 2 , 3 , 4 , 8 , 9 , 10 , 11 , 12 Some studies indicate that plate fixation is more advantageous for maintaining precise alignment. 9 , 13 Moreover, the use of rigid structures for internal fixation can reduce the risk of complications, particularly avascular necrosis and malunion of the talarfracture.…”

Section: Introductionmentioning

confidence: 99%

“…Over the past two decades, there has been a gradual increase in research and publications concerning the application of mini‐plates in the treatment of talarfractures 2–4,8–12 . Some studies indicate that plate fixation is more advantageous for maintaining precise alignment 9,13 .…”

Section: Introductionmentioning

confidence: 99%

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Treatment of Complex Central Talar Fractures with Lateral Plate Combination with Medial Screw Fixation

He,

Li,

Cao

et al. 2024

Orthopaedic Surgery

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ObjectiveThe treatment of talar neck and/or body fractures is known to be difficult and challenging, with significant impact on the long‐term functional outcome for the patient. The optimal management, including the choice of surgical approaches and implants, are still under constant discussion. The purpose of the study was to investigate the clinical effects of lateral mini‐plate combined with medial lag screws for the treatment of complicated central talar fractures.MethodsThe data of eight patients with complex central talus fractures treated between June 2019 and January 2021 were retrospectively analyzed. There were six males and two females, ranging in age from 15 to 66 years, with an average age of 37.4 years. There were three cases on the left and five cases on the right. All fractures were comminuted, including talar neck with talar body fracture in seven cases and talar body comminuted with subluxation of subtalar joint in one case. All patients were treated with the anteromedial combined anterolateral approach, lateral talar mini‐plate fixation and medial lag screw fixation. Fracture reduction quality, union time, and complications were recorded, and functional outcomes were evaluated using the American Orthopedic Foot & Ankle Society (AOFAS) scoring system.ResultsThe time from injury to surgery was 1–6 days, with an average of 3.38 days. The follow‐up period was 34–53 months (mean 44.88 months). All fractures healed with a mean healing time of 16.75 weeks (13–23 weeks). Anatomical reduction was observed in six cases and near in two cases. After operation, there was no loosening or breakage of implant, loss of fracture reduction, and irritation of skin and soft tissue by internal fixation. The average AOFAS score was 87.38 (48–100), with excellent five cases, good two cases and poor one case, and the excellent and good rate was 87.5%. Superficial skin necrosis in one surgical incision healed after dressing exchange. No deep infection occurred. One case (1/8, 12.5%) developed avascular necrosis of the talus without collapse. Posttraumatic arthritis was found in four cases (4/8, 50%).ConclusionThe utilization of lateral mini‐plates in combination with medial screws for treating complex central talar fractures results in satisfactory reduction and stable fixation, mitigating complications associated with poor reduction. However, due to the absence of an anatomical mini‐plate, pre‐contouring is necessary when applying the lateral plate. This demands a surgeon's thorough familiarity with the anatomical morphology of the talus and proficiency in surgical techniques. Posttraumatic arthritis is the most common complication of complex central talar fractures.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%