Article

Displaced talar neck and body fractures are rare and challenging
for the surgeon. Results are often disappointing due to inadequate reduction or
internal fixation and high rates of osteoarthritis and osteonecrosis. Very few
published series describe the long-term results after internal fixation of talar
factures. One of the goals of the 2011 SOO meeting symposium was to specifically
evaluate the long-term results after internal fixation of talar fractures. This
study included only central fractures. We reviewed the
results of 114 central talar fractures that had been treated by internal fixation
between 1982 and 2006 in nine hospitals in the Western part of France. The
clinical and radiological follow-up was 111 months on average. All the patients
with a radiological assessment had at least 5 years of follow-up. RESULTS: Poor
reduction was apparent in 33% of cases. The average Kitaoka score was 70/100,
which corresponds to an average functional level. At the last follow-up
evaluation, 34% of cases had osteonecrosis and 74% had peritalar osteoarthritis.
Secondary fusion was required in 25% of cases with an average follow-up of 24
months. DISCUSSION:
The complication rate for talar fractures was high, mostly
due to osteonecrosis and osteoarthritis; these conditions had an impact on the
final outcome. The outcome could be improved by better evaluating these fractures
with a CT scan, developing dual surgical approaches to best preserve the bone
vascular supply and achieve better reduction, and improving the internal fixation
hardware, especially the use of plates for comminuted fractures.
CI - Copyright (c) 2012 Elsevier Masson SAS. All rights reserved.

Langue : FRANCAIS