Clinical outcome and concomitant injuries in operatively treated fractures of the lateral process of the talus

Hörterer, Hubert; Baumbach, Sebastian Felix; Lemperle, Stefan M.; Altenberger, Sebastian; Gottschalk, Oliver; Mehlhorn, Alexander T.; Röser, Anke; Walther, Markus

doi:10.1186/s12891-019-2603-3

Cited by 10 publications

(11 citation statements)

References 37 publications

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“…Non-significant difference of AOFAS scores in group 1 and group 2 after 12 months. lateral process of the talus than plain radiographs 24 . If a fracture was suspected with plain radiographs, then an urgent CT scan was recommended in order to identify the fracture and assess the size and fracture fragment.…”

Section: Discussionmentioning

confidence: 94%

Initial assessment of treatment of talar posterior process fractures with open reduction and percutaneous fixation

Mao

Wang

Zhao

et al. 2020

Sci Rep

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The purpose of this study was to provide an initial assessment of treatment for talar posterior process fractures using open reduction and internal fixation (ORIF) through posteromedial approach and percutaneous screw fixation. From January 2014 to December 2018, 12 cases with displaced fracture of talar posterior process were treated in our department. The clinical and radiological results were assessed after 4 and 12 months of operation with Visual Analog Scale (VAS) pain and American Orthopedic Foot and Ankle Society (AOFAS) scores. ORIF was performed in four of the cases and percutaneous screw fixation was performed in eight of the cases. The average follow-up period was 13 months. Complications such as wound infection, nerve injury, screw loosening, malunion or nonunion of fracture were absent. For clinical assessment, considerable mprovements were observed for the AOFAS and VAS scores at 4 and 12 months postoperatively for both techniques. There was no significant difference for AOFAS scores and VAS scores between the two techniques (p > 0.05). Both techniques showed good functional outcome and were performed for posterior talar process fracture following the fracture displacement guidelines. Percutaneous screw fixation treatment with computer-assisted three-dimensional evaluation shortened the operation time and reduced incidences of surgical complications.

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Section: Discussionmentioning

confidence: 94%

Initial assessment of treatment of talar posterior process fractures with open reduction and percutaneous fixation

Mao

Wang

Zhao

et al. 2020

Sci Rep

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“…Although various foot classi cation systems, such as the AO/OTA classi cation or Sneppen classi cation [25], do include LTPF, Hawkins as well as McCrory and Bladin are the only two classi cations speci cally focusing on LTPF [11,12,17]. Unfortunately, both classi cations are based on plain radiographs and therefore underestimate the extent of these fractures due to the complexity of the ankle joint [26].…”

Section: Discussionmentioning

confidence: 99%

“…Prompt and accurate diagnosis and classi cation of LTPF are crucial for optimized perioperative management [16]; moreover, detailed and extensive knowledge of concomitant injuries are conductive in surgical scheme making and contributed to obtaining of a better surgical outcomes. Sadly, up to date we are missing a comprehensive classi cation for the LTPF, which should include evaluation of LTPF and their concomitant injuries based on CT scan [17].…”

Section: Introductionmentioning

confidence: 99%

Fractures of the Lateral Process of the Talus: A New Classification Based on CT

Wang

Zhu

Deng

et al. 2021

Preprint

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Background: The common classifications of the fractures of the lateral process of the talus（LTPFs）are based on radiographs and may underestimate the complexity of LTPF, therefore, requiring a comprehensive classification based on CT(Computed tomography) scan. The aim of this study is to propose a such classification system, and to evaluate its reliability and reproducibility.Methods: On the basis of the most widely recognized classifications of Hawkins as well as McCrory-Bladin, we proposed a new and comprehensive classification based on CT scan for the LTPF. We retrospectively reviewed 42 patients involving LTPF. All fractures were classified according to Hawkins, McCrory-Bladin and new proposed classification system by three surgeons. The analysis of interobserver and intraobserver agreements was done using kappa statistics.Results: This new classification included two types based on presence of concomitant injuries or not, with type I consisting of three subtypes and type II of five subtypes. Interobserver and intraobserver reliability of the new classification system were almost perfect (κ=0.846 and 0.823, respectively)，showing a higher interobserver and intraobserver reliability compared to the Hawkins classification (κ=0.737 and 0.689, respectively) as well as McCrory-Bladin classification (κ=0.748 and 0.714, respectively). Conclusion: This new classification system for the LTPF based on CT is a comprehensive classification considering concomitant injuries. It is more reliable and reproducible and can potentially become a useful instrument for decision making of treatment options for LTPFs. Further studies on the evaluation of their clinical relevance (especially the long-term outcome) are warranted.

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“…Although various foot classi cation systems, such as the AO/OTA classi cation or Sneppen classi cation [22], do include LTPF, Hawkins as well as McCrory and Bladin are the only two classi cations speci cally focusing on LTPF [11,12,17]. Unfortunately, both classi cations are based on plain radiographs.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

New Classification Based on CT and Its Value Evaluation for Fractures of the Lateral Process of the Talus

Wang¹,

Deng²,

Zhu³

et al. 2021

Preprint

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Background : The common classifications of the fractures of the lateral process of the talus（LTPFs）are based on radiographs and may underestimate the complexity of LTPF, therefore. The aim of this study was to propose a comprehensive CT-based classification system, and to evaluate its prognostic value, reliability and reproducibility.Material and Methods: We retrospectively reviewed 42 patients involving LTPF and clinical and radiographic evaluations were performed at an average follow-up of 35.9 months. In order to create a comprehensive classification, a panel of experienced orthopedic surgeons discussed the cases. All fractures were classified according to Hawkins, McCrory-Bladin and new proposed classification system by four surgeons. The analysis of interobserver and intraobserver agreements was done using kappa statistics.Results: This new classification included two types based on presence of concomitant injuries or not, with type I consisting of three subtypes and type II of five subtypes. Average AOFAS score was 91.5 in the type Ia of new classification proposed, 86 in type Ib, 90.5 in type Ic, 89 in type IIa, 76.7 in type IIb, 76.6 in type IIc, 91.3 in type IId, and 83.5 in type IIe. Interobserver and intraobserver reliability of the new classification system were almost perfect (κ=0.846 and 0.823, respectively)，showing a higher interobserver and intraobserver reliability compared to the Hawkins classification (κ=0.737 and 0.689, respectively) as well as McCrory-Bladin classification (κ=0.748 and 0.714, respectively). Conclusion: The new classification system is a comprehensive one that takes into account concomitant injuries and it shows good prognostic value with clinical outcomes. It is more reliable and reproducible and could be a useful tool for decision-making on treatment options for LTPFs.

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Clinical outcome and concomitant injuries in operatively treated fractures of the lateral process of the talus

Cited by 10 publications

References 37 publications

Initial assessment of treatment of talar posterior process fractures with open reduction and percutaneous fixation

Initial assessment of treatment of talar posterior process fractures with open reduction and percutaneous fixation

Fractures of the Lateral Process of the Talus: A New Classification Based on CT

New Classification Based on CT and Its Value Evaluation for Fractures of the Lateral Process of the Talus

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