Abstract
Purpose
We evaluated the complications, radiological and clinical results after operative treatment using a mini-plate for fixation of displaced talar neck fractures.
Materials and Methods
There were 20 cases of displaced talar neck fractures from May 2006 to December 2011; we performed a retrospective chart review of 15 patients treated by open reduction and internal fixation using a mini-plate who had more than 2 years of follow-up. According to Hawkin's classification, there were 7 cases of type II fractures and 8 cases of type III fractures. During postoperative 12-16 weeks we checked magnetic resonance imaging. The assessment of clinical results was based on the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale.
Results
Mean union period was 11.6 weeks (10-15 weeks). Nonunion and malunion did not occur in all cases. The mean AOFAS score was 88.2 points (80-97 points). There were 5 cases of avascular necrosis. Of these, there were 3 cases of body collapse and 4 cases of post-traumatic arthritis. In the statistical analysis, there was no correlation between the elements including gender, Hawkin's classification and union rates and clinical results.
Figures and Tables
Fig. 1
Intraoperative photograph shows fracture site exposure by medial malleolar osteotomy and fixation using a mini-plate on the superior portion of the deltoid ligament attachment site.
![jkfs-28-215-g001](/upload/SynapseData/ArticleImage/0104jkfs/jkfs-28-215-g001.jpg)
Fig. 2
(A-D) The preoperative simple radiographs and 3-dimensional computed tomography show a Hawkin's type III comminuted talar neck fracture. (E-G) Comminuted talar neck fracture was fixed by a miniplate and medial malleolar osteotomy was fixed by a 4.0 cannulated screw.
![jkfs-28-215-g002](/upload/SynapseData/ArticleImage/0104jkfs/jkfs-28-215-g002.jpg)
References
1. Baumhauer JF, Alvarez RG. Controversies in treating talus fractures. Orthop Clin North Am. 1995; 26:335–351.
![crossref](/image/icon/bnr_ref_cross.gif)
![crossref](/image/icon/bnr_ref_cross.gif)
2. Halvorson JJ, Winter SB, Teasdall RD, Scott AT. Talar neck fractures: a systematic review of the literature. J Foot Ankle Surg. 2013; 52:56–61.
![crossref](/image/icon/bnr_ref_cross.gif)
![crossref](/image/icon/bnr_ref_cross.gif)
6. Grob D, Simpson LA, Weber BG, Bray T. Operative treatment of displaced talus fractures. Clin Orthop Relat Res. 1985; (199):88–96.
![crossref](/image/icon/bnr_ref_cross.gif)
![crossref](/image/icon/bnr_ref_cross.gif)
7. Lorentzen JE, Christensen SB, Krogsoe O, Sneppen O. Fractures of the neck of the talus. Acta Orthop Scand. 1977; 48:115–120.
![crossref](/image/icon/bnr_ref_cross.gif)
![crossref](/image/icon/bnr_ref_cross.gif)
8. Cronier P, Talha A, Massin P. Central talar fractures--therapeutic considerations. Injury. 2004; 35:Suppl 2. SB10–SB22.
![crossref](/image/icon/bnr_ref_cross.gif)
![crossref](/image/icon/bnr_ref_cross.gif)
9. Sangeorzan BJ, Wagner UA, Harrington RM, Tencer AF. Contact characteristics of the subtalar joint: the effect of talar neck misalignment. J Orthop Res. 1992; 10:544–551.
![crossref](/image/icon/bnr_ref_cross.gif)
![crossref](/image/icon/bnr_ref_cross.gif)
10. Ohl X, Harisboure A, Hemery X, Dehoux E. Long-term follow-up after surgical treatment of talar fractures: twenty cases with an average follow-up of 7.5 years. Int Orthop. 2011; 35:93–99.
11. Penny JN, Davis LA. Fractures and fracture-dislocations of the neck of the talus. J Trauma. 1980; 20:1029–1037.
![crossref](/image/icon/bnr_ref_cross.gif)
![crossref](/image/icon/bnr_ref_cross.gif)
13. Peterson L, Goldie IF. The arterial supply of the talus. A study on the relationship to experimental talar fractures. Acta Orthop Scand. 1975; 46:1026–1034.
![crossref](/image/icon/bnr_ref_cross.gif)
![crossref](/image/icon/bnr_ref_cross.gif)
14. Canale ST, Kelly FB Jr. Fractures of the neck of the talus. Long-term evaluation of seventy-one cases. J Bone Joint Surg Am. 1978; 60:143–156.
![crossref](/image/icon/bnr_ref_cross.gif)
![crossref](/image/icon/bnr_ref_cross.gif)
16. Fleuriau Chateau PB, Brokaw DS, Jelen BA, Scheid DK, Weber TG. Plate fixation of talar neck fractures: preliminary review of a new technique in twenty-three patients. J Orthop Trauma. 2002; 16:213–219.
![crossref](/image/icon/bnr_ref_cross.gif)
![crossref](/image/icon/bnr_ref_cross.gif)
17. Frawley PA, Hart JA, Young DA. Treatment outcome of major fractures of the talus. Foot Ankle Int. 1995; 16:339–345.
![crossref](/image/icon/bnr_ref_cross.gif)
![crossref](/image/icon/bnr_ref_cross.gif)
18. Sanders DW, Busam M, Hattwick E, Edwards JR, McAndrew MP, Johnson KD. Functional outcomes following displaced talar neck fractures. J Orthop Trauma. 2004; 18:265–270.
![crossref](/image/icon/bnr_ref_cross.gif)
![crossref](/image/icon/bnr_ref_cross.gif)
19. Vallier HA, Nork SE, Barei DP, Benirschke SK, Sangeorzan BJ. Talar neck fractures: results and outcomes. J Bone Joint Surg Am. 2004; 86:1616–1624.
![crossref](/image/icon/bnr_ref_cross.gif)
![crossref](/image/icon/bnr_ref_cross.gif)
20. Fortin PT, Balazsy JE. Talus fractures: evaluation and treatment. J Am Acad Orthop Surg. 2001; 9:114–127.
![crossref](/image/icon/bnr_ref_cross.gif)
![crossref](/image/icon/bnr_ref_cross.gif)
21. Attiah M, Sanders DW, Valdivia G, et al. Comminuted talar neck fractures: a mechanical comparison of fixation techniques. J Orthop Trauma. 2007; 21:47–51.
![crossref](/image/icon/bnr_ref_cross.gif)
![crossref](/image/icon/bnr_ref_cross.gif)
23. Swanson TV, Bray TJ, Holmes GB Jr. Fractures of the talar neck. A mechanical study of fixation. J Bone Joint Surg Am. 1992; 74:544–551.
![crossref](/image/icon/bnr_ref_cross.gif)
![crossref](/image/icon/bnr_ref_cross.gif)