Abstract

The purpose of this study was to provide an initial assessment of treatment for talar posterior process fractures using open reduction and internal fixation (ORIF) through posteromedial approach and percutaneous screw fixation. From January 2014 to December 2018, 12 cases with displaced fracture of talar posterior process were treated in our department. The clinical and radiological results were assessed after 4 and 12 months of operation with Visual Analog Scale (VAS) pain and American Orthopedic Foot and Ankle Society (AOFAS) scores. ORIF was performed in four of the cases and percutaneous screw fixation was performed in eight of the cases. The average follow-up period was 13 months. Complications such as wound infection, nerve injury, screw loosening, malunion or nonunion of fracture were absent. For clinical assessment, considerable mprovements were observed for the AOFAS and VAS scores at 4 and 12 months postoperatively for both techniques. There was no significant difference for AOFAS scores and VAS scores between the two techniques (p > 0.05). Both techniques showed good functional outcome and were performed for posterior talar process fracture following the fracture displacement guidelines. Percutaneous screw fixation treatment with computer-assisted three-dimensional evaluation shortened the operation time and reduced incidences of surgical complications.

Highlights

  • The purpose of this study was to provide an initial assessment of treatment for talar posterior process fractures using open reduction and internal fixation (ORIF) through posteromedial approach and percutaneous screw fixation

  • Most reports of talar posterior process fractures are associated with subtalar ­dislocation[7,8,9] and the recommended treatment is early open reduction and internal fixation (ORIF) or percutaneous screw f­ixation[8]

  • The purpose of this study was to provide an initial assessment of treatment for talar posterior process fractures using ORIF through posteromedial approach and percutaneous screw fixation

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Summary

Introduction

The purpose of this study was to provide an initial assessment of treatment for talar posterior process fractures using open reduction and internal fixation (ORIF) through posteromedial approach and percutaneous screw fixation. There was no significant difference for AOFAS scores and VAS scores between the two techniques (p > 0.05) Both techniques showed good functional outcome and were performed for posterior talar process fracture following the fracture displacement guidelines. Most reports of talar posterior process fractures are associated with subtalar ­dislocation[7,8,9] and the recommended treatment is early open reduction and internal fixation (ORIF) or percutaneous screw f­ixation[8]. ORIF for extensive posterior talar fractures has been reported to provide good functional outcome, quality of life and patient s­ atisfaction[11] This technique is the most common treatment described in previous ­literature[12,13,14]. VAS scores Preoperative 4 months postoperatively 12 months postoperatively of optimal treatment methods depends on fragment size, degree of displacement, subtalar joint involvement and articular surface intervention

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