Avascular Necrosis after Operative Treatment for Fracture and Dislocations of the Talar Neck.
- Author:
Il Kyu KONG
1
;
Hyoung Yeon SEO
;
Keun Bae LEE
Author Information
1. Department of Orthopaedic Surgery, Chonnam National University Medical School and Hospital, Gwangju, Korea. kbleeos@chonnam.ac.kr
- Publication Type:Original Article
- Keywords:
Talar neck;
Fracture and dislocations;
Hawkins sign;
Avascular necrosis
- MeSH:
Dislocations;
Humans;
Incidence;
Neck;
Necrosis
- From:Journal of Korean Foot and Ankle Society
2008;12(2):163-167
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To evaluate the incidence of avascular necrosis (AVN), prognostic reliability of the Hawkins sign, and clinical outcomes after operative treatment of fracture and dislocations of the talar neck. MATERIALS AND METHODS: We analysed 16 patients with fracture and dislocations of the talar neck which were treated by open reduction and internal fixation and followed up for more than 2 years. The postoperative radiographs were examined for Hawkins sign and avascular necrosis was confirmed by bone scan. The assessment of clinical results was based on the Hawkins scoring system. RESULTS: AVN was occurred in 2 of 16 cases (12.5%) only in type III. Hawkins sign was found 11 of 16 cases (68.8%), which included 8 cases in type II, 2 cases in type III and 1 case in type IV. The Hawkins sign was not observed in two cases with AVN. In contrast, only 2 of the 5 cases with a negative Hawkins sign developed AVN. According to Hawkins scoring system, 4 patients (25.0%) was in excellent, 7 patients (43.8%) in good, 4 patients (25.0%) in fair and 1 patient (6.3%) in poor. CONCLUSION: Incidence of AVN after operative treatment of fracture and dislocations of the talar neck was lower than that of previous reports. Hawkins sign had a high prognostic reliability, but absence of Hawkins' sign should not be considered a totally reliable indicator of development of avascular necrosis.
