Fractures and Dislocations of the Talus: Experience of a Second Level Hospital

Abstract

Thirty-eight patients with fracture or dislocation of the talus were retrospectively reviewed in the period between 1994-2000. The mean of age was 30.7 years (range 13 to 62) and there were 29 men (76.3 %) and 9 women (23.7 %). The most common mechanism of injury was as a motor vehicle accident (43.7 %) and falling from height (25 %). Sixteen of the fractures (42.10 %), were neck fractures, eleven (28.94 %) were body fractures, four cases (10.52 %) belong to head fractures - 2 osteochondral fracture -, and 7 cases were dislocations of the talus (18.42 %). Twelve cases (31.6 %) were treated using non-surgical methods with short leg cast non-weight-bearing for 8 to 12 weeks and twenty-six cases (68.4 %) underwent operative treatment. The average follow-up period was 18 months (range 12 to 53 months). The results have been measured following the Clinical Rating System for the Ankle-Hindfoot of the American Orthopaedic Foot and Ankle Society. 34.21 % of the patients had > 70 points, 39.47 % had between 40-70 points and 26.32 % had < 40 points. We included a subjective scale to measure the final result - patient satisfaction, stair- walking ability, running ability, swelling and tenderness -. As complications we had seven cases of avascular necrosis, two cases of infection - one with non-union which needed Blair's fusion -, eight cases of osteoarthritis, three of them had subsequent subtalar fusion. A case of wound infection and another of skin necrosis. Treatment with calcium and calcitonin were necessary in eight patients with osteoporosis. We had no neurovascular deficit and no sympathetic dystrophy.

Key words

Talar body - talar neck - closed fracture - dislocation - classification

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