Clinical and radiological outcomes of internal fixation of complex talar neck and body fractures with locking plates through a dual approach - 26/10/22
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Highlights |
• | Complex talar fractures are rare. |
• | Surgical management of these fractures is difficult. |
• | Double approach limits the devascularization of fractured talus. |
• | Dedicated specific locking plates allow osteosynthesis of quality. |
Abstract |
Introduction |
Talar fractures are rare and surgical treatment has not been standardized. The literature is rather poor on preserving talar vascularization in single or dual approaches. A dual approach allows better exposure and should limit devascularization. Locking plates are one of the modern solutions for challenging comminuted fractures. The aim of this study was to determine clinical and radiological outcomes in complex talar fracture (CTF) of the neck and body, fixed by locking plates through a dual approach with at least one locking plate.
Hypothesis |
Locking-plate fixation of CTF through a dual approach leads to good clinical outcome.
Material and methods |
A single-center retrospective study included 12 cases of CTF treated between January 2007 and May 2019. 3D CT was systematically performed to plan surgery. A dual approach and at least one locking plate were used for fixation. Clinical outcome was evaluated on AOFAS score. Reduction quality and correlation to clinical results were evaluated, reduction with<2mm joint step being considered satisfactory. Consolidation rate and occurrence of avascular necrosis of the talus (ANT), post-traumatic arthritis (PTA) and postoperative complications were analyzed.
Results |
Mean follow-up was 27 months (range, 15–47). Mean AOFAS score was 70±18 (range, 30–97). Inframillimetric reduction was achieved in 67% of cases, without significant correlation with clinical results. The consolidation rate was 91.6%, ANT rate 18.2% and PTA rate 45.5%. One patient presented septic osteoarthritis secondary to scar necrosis.
Conclusion |
Locking plate fixation of CTF through a dual approach provided acceptable clinical outcomes.
Level of evidence |
IV; retrospective study.
Le texte complet de cet article est disponible en PDF.Keywords : Talus, Talar fracture, Comminuted fracture, Dual approach, Locking plate
Plan
Vol 108 - N° 7
Article 103368- novembre 2022 Retour au numéro
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