Outcomes of Talar Neck Fractures

Dodd, Andrew; Lefaivre, Kelly A.

doi:10.1097/bot.0000000000000297

Cited by 84 publications

(40 citation statements)

References 29 publications

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“…Despite several decades have passed, with inherent progress in surgical techniques, equipment and management of soft tissue injuries, the rate of post-traumatic ON is still considerable, as proven by the data emerged from the present review, which focused on clinical trials published in the last 30 years. Anyway, a recent meta-analysis has suggested that surgical managament of talar fractures, which became routine only after 1990, has contributed to reduce the rate of ON, especially in Hawkins II and III neck fractures [30]. Surprisingly, the present review found a large variability among studies regarding the incidence of post-traumatic ON, with some trials reporting values as low as 10% and others presenting higher incidence, up to 50% of cases.…”

Section: Discussionmentioning

confidence: 54%

“…There is no clear evidence whether a fixation technique (screws vs plate vs K wires) is better than the other, nor if there are surgical tricks (e.g. screws placed anterior to posterior rather than posterior to anterior) that could improve clinical outcome [30]. Similarly, the use of a double surgical approach does not seem to increase the risk of ON with respect to the single access [10].…”

Section: Discussionmentioning

confidence: 99%

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Complications after Displaced Talar Neck Fracture: Results from a Case Series and a Critical Review of Literature

Leonetti¹,

Matteo²,

Barca³

et al. 2018

TOORTHJ

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Introduction: Talar fractures are uncommon injuries, whose outcome is often characterized by the onset of serious complications. The aims of the present study are: 1) to review the available evidence concerning the outcome and complications of talar neck fractures; 2) to describe the clinical results and the rate of post-op complications in a series of patients treated surgically after talar fracture-dislocations. Materials and methods: The review of the literature was performed on the Pubmed, Embase and Web of Science databases and aimed at identifying clinical trials with at least 10 patients and dealing with surgical management of talar fracture-dislocation (Hawkins grade II to IV). All the papers were analyzed to extract data concerning common complications such as non-union, mal-union, infection, osteonecrosis and osteoarthtritis. The clinical arm of this paper included 26 patients (19 men and 7 women), who underwent fixation of displaced talar fracture by cannulated screws and were retrospectively evaluated, both clinically and radiographically, at a mean 51.2 ± 23.4 months of follow-up. Results: The evaluation through the AOFAS score revelead a loss of functional performance with respect to the pre-injury status. Four patients were re-operated within final follow up, whereas the remaining 22 presented excellent results in 2 cases, good results in 4 cases, fair results in 11 cases and poor results in 5 cases. Osteoarthritis and osteonecrosis incidence were 51.9% and 25.9% respectively. Sixteen studies were included in the review and it was confirmed that the most frequent complication was post-traumatic OA, followed by osteonecrosis and mal-union. A variable range in percentage of complications described should be ascribed to the low quality of trials currently available. Conclusion: Displaced talar fracture are challenging to treat and the outcomes at middle-term are often modest. Looking at complications, the present case series and the review of literature revealed that the most common one is peritalar OA. Osteonecrosis, traditionally regarded as the most fearsome adverse event, is relevant but less frequent than OA.

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Complications after Displaced Talar Neck Fracture: Results from a Case Series and a Critical Review of Literature

Leonetti¹,

Matteo²,

Barca³

et al. 2018

TOORTHJ

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“…The second most common complication is subtalar arthritis. [4] Elgafy et al reported an association of 53.3 percent subtalar arthritis and 25 percent tibiotalar arthritis with talus fractures. [5] Failure to prevent these complications will lead to chronic pain, disability, and multiple surgeries.…”

Section: Introductionmentioning

confidence: 98%

Management of 6 Months old Neglected Talus Neck Fracture: A Case Report with Review of Literature

Moger

Pragadeeshwaran

Sarkar

et al. 2020

AJMR

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Talus fractures are very rarely seen and account for approximately 1 percent of fractures around the foot and ankle Talar neck fractures are likely to damage the anastomotic ring, resulting in disruption of blood supply to the talar body which leads to significant problems in fracture healing and integrity. Approximately 39 percent of midfoot and ankle fractures could be missed during initial evaluation due to a lack of adequate radiological and clinical examination. Among these missed injuries approximately 50 percent are talus fractures. A 23-year-old male patient came with complaints of pain over the left foot while walking for 6 months. He had a history of falls from 10 feet height 6 months back. He was conservatively managed in a local hospital without any proper diagnosis. He presented to us 6 months later with chronic, dull aching, continuous pain which aggravates while walking and standing. The diagnosis of the non-union fracture neck of talus was made after radiology and was managed by open reduction and internal fixation with cannulated cancellous screws along with ipsilateral iliac crest cancellous bone grafting. Lack of timely diagnosis escalates the vascular insult, delays timely intervention, and increases morbidity.

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“…The most dreaded complication of talar neck fracture is osteonecrosis of the body of talus which ultimately leads to collapse of the body. Subtalar arthritis is the 2nd most common complication observed following a talar neck fracture [ 4 ]. The complications can be as high as 53.3% with subtalar arthritis and 25% with tibiotalar arthritis as reported by Elgafy et al [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Outcome of neglected talus neck fracture and it’s management: A Case Report

Moger¹,

Pragadeeshwaran²,

Verma³

et al. 2021

JOCR

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Introduction: Talus fracture is an uncommon fracture that can be encountered on day- to- day basis. However, it is the 2nd most common tarsal bone to get fractured after calcaneum and accounts for approximately 1% of all fractures around foot and ankle. The anastomotic ring around the talar neck is highly likely to get damaged at the time of the fracture, which, in turn, hampers the blood supply to the body of talus. As a result, the bone healing is delayed and the integrity of the healed fracture is poor which leads to poor functional outcome. Almost 39% cases are missed during the initial evaluation, and talus fracture accounts for almost 50% of all the missed injuries (6–8). A high level of clinical suspicion is required to avoid missing such injuries. Case Report: A 26-year-old male presented to the outpatient department with chief complaint of pain over the left foot while walking for past 6 months. There was a history of significant trauma to the foot 6 months back (fall from 12 feet) for which he sought medical advice and was managed with analgesics and rest for a couple of weeks. He presented to us 6 months later with chronic, dull aching, and continuous pain which aggravates while walking and standing. The diagnosis of the non-union fracture neck of talus was made after radiology and was managed by open reduction and internal fixation with cannulated cancellous screws along with contralateral iliac crest cancellous bone grafting. Conclusion: Delay in diagnosing such injuries accelerates the vascular compromise, delays timely intervention, and ultimately leads to increased morbidity. Keywords: Talar neck fracture, non-union talus fracture, delayed union talus.

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Outcomes of Talar Neck Fractures

Cited by 84 publications

References 29 publications

Complications after Displaced Talar Neck Fracture: Results from a Case Series and a Critical Review of Literature

Complications after Displaced Talar Neck Fracture: Results from a Case Series and a Critical Review of Literature

Management of 6 Months old Neglected Talus Neck Fracture: A Case Report with Review of Literature

Outcome of neglected talus neck fracture and it’s management: A Case Report

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