The Result of Open Reduction and Mini-Plate Fixation for Displaced Talar Neck Fracture

Woong Chae Na; Sang Hong Lee; Jun Young Lee; Sang Jun Lee; Boseon Kim

doi:10.12671/jkfs.2015.28.4.215

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Na, Lee, Lee, Lee, and Kim: The Result of Open Reduction and Mini-Plate Fixation for Displaced Talar Neck Fracture

Original Article

Journal of the Korean Fracture Society 2015; 28(4): 215-222.

Published online: 19 October 2015

DOI: https://doi.org/10.12671/jkfs.2015.28.4.215

The Result of Open Reduction and Mini-Plate Fixation for Displaced Talar Neck Fracture

Woong Chae Na, M.D., Sang Hong Lee, M.D., Jun Young Lee, M.D., Ph.D, Sang Jun Lee, M.D., Boseon Kim, M.D.

Department of Orthopaedic Surgery, Chosun University School of Medicine, Gwangju, Korea.

Address reprint requests to: Jun Young Lee, M.D., Ph.D. Department of Orthopaedic Surgery, Chosun University Hospital, 365 Pilmun-daero, Dong-gu, Gwangju 61453, Korea. Tel: 82-62-220-3147, Fax: 82-62-226-3379, leejy88@chosun.ac.kr

Received 22 May 2015 Revised 8 July 2015 Accepted 26 July 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Conclusion

Mini-plate fixation of a displaced talar neck fracture is thought to be a good technique, with a low rate of malunion and also showed satisfactory results in radiological and clinical assessment.

Keywords: Talar neck, Displaced fracture, Mini-plate

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.

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.

Table 1

Demographic Data

AOFAS: American Orthopaedic Foot and Ankle Society, F/D: Fall down, T/A: Traffic accident, AVN: Avascular necrosis, OA: Osteoarthritis, N/A: Normal alignment.

Table 2

Radiographic Results

Values are presented as number/total number (%) or median (range). p-value: age, 0.981; gender, 0.327; Hawkin's type, 0.482.

Table 3

Clinical Results

Values are presented as median (range) or number±standard deviation. p-value: age, 0.221; gender, 0.584; Hawkin's type, 0.823.

Notes

^{Financial support} This study was supported by research fund from Chosun University, 2014.

^{Conflict of interest} None.

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