Z Orthop Unfall
DOI: 10.1055/a-1023-4715
Original Article/Originalarbeit
Georg Thieme Verlag KG Stuttgart · New York

Surgical Treatment of Talar Neck and Body Fractures: Mid-Term Results of 24 Cases

Article in several languages: English | deutsch
Dominik von Winning
1  Department for Trauma Surgery, Otto-von-Guericke University, Magdeburg Medical Faculty
,
Daniela Adolf
2  Company for Clinical and Healthcare Research mbH, StatConsult, Magdeburg
,
Wiebke Schirrmeister
1  Department for Trauma Surgery, Otto-von-Guericke University, Magdeburg Medical Faculty
,
Stefan Piatek
1  Department for Trauma Surgery, Otto-von-Guericke University, Magdeburg Medical Faculty
› Author Affiliations
Further Information

Publication History

Publication Date:
09 January 2020 (online)

Abstract

Background Talar neck and body fractures are rare. Major posttraumatic complications with a potential reduction in the quality of life are arthrosis and necrosis due to the specific vascular supply. The aim of the study was to evaluate mid-term results of surgery for talar fractures of neck and body. Parameters that potentially affected/influenced treatment outcomes were analysed exploratively.

Methods 24 patients with 24 talar neck and body fractures (Marti type II n = 9, type III n = 12, type IV n = 3) were retrospectively examined for radiological and clinical functional outcomes. The independent parameters evaluated included age (< 40, ≥ 40 years), sex (male, female), general overall extent of injury (polytrauma/multiple injuries/multiple fractures of the extremities, additional injuries to the same foot, isolated talus fracture), soft tissue damage (open, closed), surgical latency (< 6, ≥ 6 h), fracture classification/displacement (undisplaced [= Marti II], displaced [= Marti III, IV]) and fracture type (talar body, neck fracture). The potential influencing parameters were analysed by univariate analyses.

Results With an average follow-up of 8.7 years (1,25 – 16 years) the AOFAS score was 71.4 ± 22.9 points, the Foot Function Index score 35.9 ± 28.3 points; the physical and mental component summary scores of the Short Form 36, version 2, was 43.8 ± 10.9 and 47.4 ± 13.6 points (mean ± standard deviation), respectively. Thus, the patient reported physical health of the patients was slightly reduced compared to the German population, while the mental health remained largely unaffected. Two patients developed partial avascular necrosis (8%), 10 patients developed osteoarthritis (42%). Of the independent parameters, only the general overall extent of injury showed a significant influence on osteoarthritis (p = 0.002). In the evaluation of undisplaced (n = 9) and displaced (n = 15) fractures, surgical treatment after more than 6 hours did not result in a worse outcome.

Conclusion The clinical outcome of internal fixation of talar neck and body fractures can be classified as good. In the study group, there was no correlation between the occurrence of arthrosis and the Marti fracture classification.