دورية أكاديمية
Operative outcomes of a high-grade talar neck fracture - Lessons from 20 years' clinical experience in a single, tertiary hospital.
| العنوان: | Operative outcomes of a high-grade talar neck fracture - Lessons from 20 years' clinical experience in a single, tertiary hospital. |
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| المؤلفون: | Choi JY; Department of Orthopaedic Surgery, Inje University Ilsan Paik Hospital, 170 Juhwa-ro, Ilsanseo-gu, Goyang-si, Gyeonggi-do, South Korea. Electronic address: osddr8151@paik.ac.kr., Kim HS; Department of Orthopaedic Surgery, Inje University Ilsan Paik Hospital, 170 Juhwa-ro, Ilsanseo-gu, Goyang-si, Gyeonggi-do, South Korea. Electronic address: i9827@paik.ac.kr., Ngissah R; Department of Orthopedic Surgery, Greater Accra Regional Hospital, Castle Rd, Accra, Ghana. Electronic address: rngissah@yahoo.com., Suh JS; Department of Orthopaedic Surgery, Inje University Ilsan Paik Hospital, 170 Juhwa-ro, Ilsanseo-gu, Goyang-si, Gyeonggi-do, South Korea. Electronic address: sjs0506@paik.ac.kr. |
| المصدر: | Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons [Foot Ankle Surg] 2023 Feb; Vol. 29 (2), pp. 118-127. Date of Electronic Publication: 2022 Dec 06. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Ltd Country of Publication: France NLM ID: 9609647 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1460-9584 (Electronic) Linking ISSN: 12687731 NLM ISO Abbreviation: Foot Ankle Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: [London] : Elsevier Ltd. Original Publication: Paris : Arnette Blackwell, c1996- |
| مواضيع طبية MeSH: | Fractures, Bone*/diagnostic imaging , Fractures, Bone*/surgery , Talus*/diagnostic imaging , Talus*/surgery , Talus*/injuries , Fractures, Ununited*/etiology , Osteoarthritis*/diagnostic imaging , Osteoarthritis*/etiology , Osteoarthritis*/surgery, Humans ; Fracture Fixation, Internal/adverse effects ; Retrospective Studies ; Tertiary Care Centers ; Treatment Outcome |
| مستخلص: | Background: The operative treatment of high-grade talar neck fractures remains challenging, despite numerous previous reports. Our goal was to determine long-term outcomes and to establish a plan for management of postoperative complications (especially, avascular necrosis [AVN] of talar body) after high-grade talar neck fractures. We hypothesized that not every case with AVN of talar body require secondary surgical interventions. Methods: We retrospectively reviewed the radiographic and clinical findings of 14 patients who underwent operative treatment for high-grade talar neck fractures (modified Hawkins type III and IV) between January 2000 and December 2017. The minimum follow-up duration for inclusion was 3 years. Using radiographs during follow-up, we assessed the development of AVN of the talar body, malunion, nonunion, and posttraumatic osteoarthritis. Information about the secondary operations and their outcomes were also investigated using visual analogue scale (VAS) and American orthopaedic foot and ankle society (AOFAS) ankle-hindfoot scale at the final follow-up. Results: In 10 of 14 patients (71.4 %), talar body AVN developed during follow-up. However, secondary operation was required in only 30.0 % (3 of 10 patients). In the remaining 7 patients who did not undergo secondary operation, the symptoms were tolerable with a maximum of 89 months follow-up; although the talar body presented sclerotic changes, but without talar dome collapse. The rates of malunion and post-traumatic subtalar osteoarthritis were 21.4 % and 14.3 %, respectively. No patients presented with fracture site nonunion. After a mean of 55.86 ± 14.45 months (range, 37-89) follow-up, the final mean VAS and AOFAS scores were 3.07 ± 0.73 (range, 2-4) and 80.43 ± 3.11 (range, 75-85), respectively. Conclusion: We recommend leaving talar body AVN untouched, unless the patient's symptoms become intolerable. In our clinical practice, postoperative AVN could be stably maintained without talar dome collapse for more than 7 years, although the sclerotic change persisted. Despite the small number of patients, our clinical experience may benefit patients with high-grade talar neck fractures and surgeons who treat such rare, serious, and challenging foot injuries. Level of Evidence: Level IV, Case series. Competing Interests: Conflict of interest Each author certifies that he has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. (Copyright © 2022 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Ankle arthrodesis; Avascular necrosis; Dislocation; Hawkins classification; Posttraumatic arthritis; Talar neck fracture; Talus; Tibiotalocalcaneal arthrodesis |
| تواريخ الأحداث: | Date Created: 20221216 Date Completed: 20230214 Latest Revision: 20230214 |
| رمز التحديث: | 20230214 |
| DOI: | 10.1016/j.fas.2022.12.002 |
| PMID: | 36526523 |
| قاعدة البيانات: | MEDLINE |
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