Fractures of the Talus

Bykov, Yu. N.

doi:10.1016/j.cpm.2014.06.004

Cited by 14 publications

(15 citation statements)

References 12 publications

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“…Blood supply to talus is limited because only the posterior aspect of the talar body and region around the neck exit receive perioster blood supply. The vascularity of the talus consists of three parts: the posterior tibial, anterior tibial, and peroneal arteries [3]. The posterior tibial artery branches out to the deltoid ligament and the artery of the tarsal canal, which is the primary vascular supply to the talar dome; thus, surgeons must aim to protect the deltoid ligament from damage during surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Talar fractures are unusual and potentially debilitating injuries that account for approximately 3 to 6% of foot fractures and less than 1% of all bone fractures [1–3]. Most of these injuries are caused by motor vehicle accidents or falls and are associated with pain, swelling, and bruising of the ankle.…”

Section: Introductionmentioning

confidence: 99%

“…Management and treatment challenges arise for these injuries due to the potential for limited blood supply, multiple articulations, and broad chondral surface area, particularly in complex multiple plane fractures of talus [3, 4]. The Hawkins system is the most widely accepted classification system for talar neck fractures and includes three classifications based on initial fracture displacement: a non-displaced fracture (type I), a displaced fracture where the subtalar joint is subluxated or dislocated (type II), and a dislocation at both the subtalar and tibiotalar joints (type III) [5].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Surgical management of Hawkins type III talar neck fracture through the approach of medial malleolar osteotomy and mini-plate for fixation

Liu¹,

Zeng²,

Xiong³

et al. 2017

J Orthop Surg Res

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BackgroundFractures of the talar neck are relatively uncommon yet current interventions suffer from a high incidence of complications and poor functional outcomes. In the present study, we report a surgical treatment of Hawkins type III talar neck fracture through the approach of medial malleolar osteotomy and mini-plate for fixation and discuss the therapeutic effects after long-term follow-up.MethodsFrom January 2010 to January 2015, 21 patients with 22 fractures were treated using this approach within days of sustaining the injury. Clinical and radiographic data were collected during regular post-operative follow-ups. Health-related quality of life factors were evaluated using visual analogue scale (VAS). Functional outcomes were determined according the Hawkins score and the Ankle-Hind foot Scale of the American Orthopedic Foot and Ankle Society (AOFAS). Present of complications such as arthritis, avascular necrosis (AVN), and malunion were evaluated using radiographs and magnetic resonance imaging (MRI). Anatomical parameters of injured and corresponding uninjured talus were measured and compared using digital three-dimensional (3D) computer model.ResultsThe mean duration of surgery was 65.6 ± 9.7 min. The average blood loss volume of the patients was 29.1 ± 5.7 ml. All the patients except 1 were followed up 18 to 41 months (average 29.6 months). The average VAS score for these patients was 3.2 ± 1.1, and the mean Hawkins score was 11.4 ± 3.4 at the final follow-up visit. The average AOFAS score was 72.8 ± 17.3. Nine patients outcomes were rated as “excellent”, 4 as “good”, 4 as “fair,” and 4 as “poor”. No malunion, screw loosening, plate breakage, or other internal fixation failures were found at final follow-up. Long-term complications included: 1 case of malunion, 5 cases of complete AVN, 8 cases of partial AVN, 13 cases of talocrural arthritis, 14 cases of subtalar arthritis, and 3 cases of talonavicular arthritis. Secondary surgery was performed in 4 cases. The relevant average anatomical data of injured and uninjured talus show no significant difference.ConclusionsThis surgical treatment we used here resulted in decreased soft tissue trauma, adequate exposure of talar neck, satisfactory performance of daily life activities, and quality of life following surgery and restoration of anatomy of injured talus. However, long-term complications such as arthritis and AVN are still commonly seen.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surgical management of Hawkins type III talar neck fracture through the approach of medial malleolar osteotomy and mini-plate for fixation

Liu¹,

Zeng²,

Xiong³

et al. 2017

J Orthop Surg Res

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“…In addition, AP view of the foot allows visualization of the talonavicular joint in that plane. 10 Lateral view of the ankle allows good visualization of the talar neck fractures. On a good lateral view, there will be a single shadow of the superior convexity of the talar body, meaning the lateral and the medial sides of the talar dome are collinear.…”

Section: Radiological Evaluationmentioning

confidence: 99%

Management of Talar Body Fractures

Sundararajan

Badurudeen

Ramakanth

et al. 2018

IJOO

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Fractures of talar body are uncommon injuries often associated with fractures of other long bones and in polytraumatized patients. The integrity of the talus is essential for the normal function of the ankle, subtalar, and midtarsal joints. The relative infrequency of this injury limits the number of studies available to guide treatment. They occur as a result of high-velocity trauma and are therefore associated with considerable soft tissue damage. Axial compression with supination or pronation is the common mechanism of injury. Great care is necessary for diagnosing and treating these injuries. Clinically, talar body fractures present with soft tissue swelling, hematoma, deformity, and restriction of motion. Associated neurovascular injury of the foot should be carefully examined. The initial evaluation should be done with foot, and ankle radiographs and computed tomography is often done to analyze the extent of the fracture, displacement, intraarticular extension, comminution, and associated fractures. Differentiating talar neck from body fractures is important. Optimal treatment relies on an accurate understanding of the injury and the goals of treatment are the restoration of articular surface and axial alignment. Indications for nonoperative management are seldom indicated and are few as in nonambulatory patients, or in with multiple comorbidities who are not able to tolerate surgery. Splinting, followed by short leg casting for 6 weeks until fracture union should be undertaken. Surgery is indicated in most of the cases, and different approaches have been described. Sometimes, a dual approach with a malleolar osteotomy is necessary for articular restoration. Clinical outcomes depend on the severity of the initial injury and the quality of reduction and internal fixation. The various complications are avascular necrosis, malunion, infections, late osteoarthritis, and ankylosis of subtalar joint.

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“…Complications of talar fractures include chronic pain, arthrosis, and rarely avascular necrosis [ 27 ]. Treatment of the Shepherd fracture is typically immobilization, although depending on symptoms, delayed excision of the fragments may be necessary [ 33 ].…”

Section: Review: Lower Extremity Fracture Eponymsmentioning

confidence: 99%

What’s in a name? Lower extremity fracture eponyms (Part 2)

et al. 2015

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Eponymous extremity fractures are commonly encountered in the emergency setting. Correct eponym usage allows rapid, succinct communication of complex injuries. We review both common and less frequently encountered extremity fracture eponyms, focusing on imaging features to identify and differentiate these injuries. We focus on plain radiographic findings, with supporting computed tomography (CT) images. For each injury, important radiologic descriptors are discussed which may need to be communicated to clinicians. Aspects of management and follow-up imaging recommendations are included. This is a two-part review: Part 1 focuses on fracture eponyms of the upper extremity, while Part 2 encompasses fracture eponyms of the lower extremity.

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Fractures of the Talus

Cited by 14 publications

References 12 publications

Surgical management of Hawkins type III talar neck fracture through the approach of medial malleolar osteotomy and mini-plate for fixation

Surgical management of Hawkins type III talar neck fracture through the approach of medial malleolar osteotomy and mini-plate for fixation

Management of Talar Body Fractures

What’s in a name? Lower extremity fracture eponyms (Part 2)

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