Combined medial and lateral incisions for treatment of talar neck fracture with talar dislocation

Abstract

Objective To investigate the effect of treatment of talar neck fractures with talar dislocation via medial and lateral incisions. Methods Between January 2010 and January 2013, 12 cases of talar neck fracture with talar dislocation were operated on via medial and lateral incisions. There were 10 males and 2 females with mean age of 32.5 years (range, 25-42 years). According to the modified Hawkins classification, there were 9 cases of type Ⅱ and 3 type Ⅲ. Seven cases of simple fracture (type Ⅱ) underwent open reduction and screw internal fixation. And five cases of comminuted fracture comprising 2 type Ⅱ and 3 type Ⅲ underwent internal fixation with mini-plates and screws. American Orthopedic Foot and Ankle Society (AOFAS) score was used for evaluation of ankle and hindfoot disorders. Results Ten patients were followed up for mean 30 months (range, 18-48 months). No wound healing problems or infections were seen. Mean postoperative AOFAS score was (78.5±8.9)points (range, 66-90 points). Mean time to fracture healing was 12.5 weeks (range, 10-16 weeks). Talar avascular necrosis was documented in 3 cases of comminuted fracture (1 type Ⅱ and 2 type Ⅲ), but none of them had collapse of the talar body. Two cases experienced the relieve of osteonecrosis 3 months after conservative therapy by decreasing activity and weight-bearing and one case underwent subtalar arthrodesis because of posttraumatic arthritis. Conclusion Combined medial and lateral incisions attains good results in treatment of talar neck fractures with talar dislocation. Key words: Talus; Dislocations; Fracture fixation, internal