Mechanical Comparison of Headless Screw Fixation and Locking Plate Fixation for Talar Neck Fractures

Karakaşlı, Ahmet; Hapa, Onur; Erduran, Mehmet; Dincer, Cemal; Çeçen, Berivan; Havıtçıoğlu, Hasan

doi:10.1053/j.jfas.2015.04.002

Cited by 19 publications

(6 citation statements)

References 20 publications

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“…Anatomical reduction and restoring and maintaining talar length, especially at areas of comminution, are crucial to preventing nonunion and malunion in these fractures. 6,16-18,27,32 Many authors recommend plate fixation with or without positional screws for comminuted talar neck fractures. 9,18,27,29 Maceroli et al 21 reported no instances of malunion when treating talar neck fractures with a lateral minifragment tension band plate and medial neutralization screws.…”

Section: Discussionmentioning

confidence: 99%

Union Rates of Talar Neck Fractures With Substantial Bone Defects Treated With Autograft

et al. 2021

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Background: This study evaluated the union rate of talar neck fractures with substantial bone defects treated acutely with autologous tibial bone graft during primary osteosynthesis. Methods: A case series at a level 1 trauma center was performed to identify consecutive patients who underwent operative fixation of talar neck fracture with autograft ( Current Procedural Terminology codes 28445 and 20902) between 2015 and 2018. “Substantial bone defect” was defined as a gap greater than 5 mm in the sagittal plane and greater than one-third of width of the talar neck in the coronal plane. Postoperative foot computed tomographic (CT) scans were obtained for all patients. Primary outcome was union, and secondary outcomes were malunion, avascular necrosis (AVN), post-traumatic arthritis (PTA), and patient-reported outcomes (PROs). Results: Twelve patients with 12 fractures were included in the series, with an average length of follow-up of 26 months (range: 7-55) The average age was 34 years (17-59), and the most common mechanism of injury was motor vehicle crash. The Hawkins classification of the fractures was 4 type II (2 type IIA and 2 type IIB) (33%) and 8 type III (67%). Four fractures (33%) were open fractures. Union was achieved in 11 patients (92%). There was 1 malunion (8%). AVN was identified on postoperative CT scans in 11 patients (92%). Three of these 11 eventually showed collapse. Ten patients (83%) had radiographic evidence of some degree of ankle PTA, and 12 patients (100%) had radiographic evidence of some degree of subtalar PTA. Average Patient-Reported Outcomes Measurement Information System–Short Form score was 37 (32-45) and average Foot and Ankle Ability Measure activities of daily living and sports subscale scores were, respectively, 61 (31-87) and 31 (0-71), respectively. Average visual analog scale score was 5 (0-10), and average Foot Function Index was 49 (7-89). SF-36 scores showed fair to poor outcomes in the majority of patients. Conclusion: In this relatively small series, tibial autograft in primary osteosynthesis of comminuted talar neck fractures with substantial bone defects is associated with excellent union rates and low malunion rates. Despite high union rates, secondary outcomes of AVN with or without collapse, ankle and subtalar PTA, and relatively low PROs were common. Level of Evidence: Level IV: Case series.

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Section: Discussionmentioning

confidence: 99%

Union Rates of Talar Neck Fractures With Substantial Bone Defects Treated With Autograft

et al. 2021

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“…Use of mini-fragment plates yields a stiffer construct than screws alone to prevent varus collapse or malunion. 5 After fixation is completed, the ankle should be taken through range of motion to look for hardware impingement and motion at the fracture site. Medial or lateral malleolus osteotomies can be performed, if necessary, to obtain visualization of fractures extending into the talar body.…”

Section: Discussionmentioning

confidence: 99%

Talar Neck and Sustentaculum Fracture Fixation

Neiman

2021

Journal of Orthopaedic Trauma

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Talar neck fractures are uncommon fractures that result from high-energy trauma causing bony and soft tissue injury. When combined with sustentaculum fractures, care must be taken to plan the approach and fracture fixation strategy. We present a 57-year-old woman who experienced a motor vehicle accident, sustaining a Hawkins II talar neck fracture with associated sustentaculum tali fracture. We demonstrate the dual-incision approach to the talar neck with medial screw and lateral plate fixation. The sustentaculum fixation was accomplished with cannulated screws through a direct medial approach.

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“…35 Medial plates have proven to be potentially symptomatic, so the use of screws (most commonly headless or countersunk) is often preferred to supplement lateral plate fixation (Figure 3). 30…”

Section: Internal Fixationmentioning

confidence: 99%

Fractures of the Talus: Current Concepts

Schwartz

Runge

Hsu

et al. 2020

Foot & Ankle Orthopaedics

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Talus fractures continue to represent a challenging and commonly encountered group of injuries. Its near-complete articular cartilage surface, and its role in force transmission between the leg and foot, makes successful treatment of such injuries a mandatory prerequisite to regained function. Familiarity with the complex bony, vascular, and neurologic anatomy is crucial for understanding diagnostic findings, treatment indications, and surgical techniques to maximize the likelihood of anatomic bony union. This review details the structure and function of the talus, a proper diagnostic workup, the treatment algorithm, and post-treatment course in the management of talus fractures. Level of Evidence: Level V, expert opinion.

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Mechanical Comparison of Headless Screw Fixation and Locking Plate Fixation for Talar Neck Fractures

Cited by 19 publications

References 20 publications

Union Rates of Talar Neck Fractures With Substantial Bone Defects Treated With Autograft

Union Rates of Talar Neck Fractures With Substantial Bone Defects Treated With Autograft

Talar Neck and Sustentaculum Fracture Fixation

Fractures of the Talus: Current Concepts

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