A study on functional outcome of Talar fractures

Abstract

Background: Talar fractures are second in frequency among all tarsal bone fractures. Two percent of all lower extremity injuries and 5% to 7% of foot injuries involve fractures of the talus. The role of the talus in lower extremity function, the complexity of the anatomy, and the variability of fracture patterns often complicate treatment of talar fractures and often frustrate orthopaedic surgeon. The primary goal of treatment is to obtain stable, pain free subtalar and ankle joints and restoration of their maximum function. Aim: To study about the functional outcome of talus fracture following internal fixation by using cannulated cancellous screws. Materials and Methods: 20 patients [11males and 9 females] admitted in government thoothukudi medical college hospital thoothukudi with ankle injuries with talus fractues were included in this study. All the patients were treated with internal fixation with cannulated cancellous screw fixation. Patients were followed up and assessed for functional outcome with AOFAS scoring and Hawkins grading criteria. Results: 20 patients with talar fractures admitted at Government Thoothukudi medical college hospital, Thoothukudi were included in the study. All the patients were treated with internal fixation with cannulated cancellous screws. The longest follow up period was 18 months and shortest follow up period was 6 months, mean follow up period was 12 months. Follow up analysis was made using AOFAS scoring and Hawkins grading criteria. In our study, 65% of patients were less than 30 years of age. 70% of patients were male and there was no significant difference in the side affected (right-9, left-11). Most of the patients sustained injury by fall from height (55%). 55% of patients had fracture of neck of talus among others. In this study, 40% of patients had excellent outcome, 30% patients had good outcome and 30% had fair outcome, while none had poor outcome. In this study, only 1 patient developed screw prominence and wound infection, treated with IV antibiotics, and screw removal done. One patient developed avascular necrosis of the talus and one another developed subtalar arthritis, both of them were treated with subtalar arthrodesis. Conclusion: In conclusion, treatment of fracture of talus with closed / open reduction and screw fixation facilitated early mobilization of the patients and helped achieving stable, pain free subtalar and ankle joints and preventing avascular necrosis of talus and subtalar and ankle joint arthritis.