Closed reduction and percutaneous screw fixation for talar neck fractures
10.3760/cma.j.issn.0253-2352.2013.11.007
- VernacularTitle:闭合复位经皮螺钉固定治疗距骨颈骨折
- Author:
Hu WANG
;
Tao SONG
;
Xun CHEN
;
Junwei WANG
- Publication Type:Journal Article
- Keywords:
Talus;
Fractures,Bone;
Fracture fixation,internal;
Surgical procedures,minimally invasive
- From:
Chinese Journal of Orthopaedics
2013;33(11):1109-1114
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the clinical outcome of closed reduction and percutaneous screw fixation for talar neck fractures,and explore the minimally invasive treatment for talar neck fractures.Methods From June 2009 to December 2012,12 cases with talar neck fracture were treated by closed reduction and percutaneous screw fixation,including 10 males and 2 females with an average age of 34 years (range,21-52).All cases are unilateral side,including five cases of left foot and seven cases of right foot.All cases are evaluated the displacement,shape and number of fracture fragments by CT before fixing the fracture.According to Hawkins classification:type Ⅰ 7 cases,type Ⅱ 5 cases.Seven patients with type Ⅰ were used direct percutaneous screw fixation,five patients with type Ⅱ were treated with closed reduction and subsequent percutaneous screw fixation.The Computed Tomography was used to evaluate the quality of close reduction.The AOFAS (ankle-hindfoot scale) scores was used to evaluation clinical outcome in follow-up,and Computed Tomography was used to evaluate the result of reduction and fixation after operation.Recording Hawkins sign according to X-ray film,recording infection,talar body necrosis,traumatic arthritis and other complications.Results Twelve patients were followed up for an average of 34 months (range,22-40).At the end of followup,the AOFAS scores was average 90 points (range,84-95).Nine patients showed Hawkins sign 6 to 10 weeks after operation,2 patients did not find Hawkins sign,but in the follow-up period didn't appear talar body necrosis.One case did not appear Hawkins sign,and who's talar body necrosis was diagnosed by MRI,but no collapse,no pain and did not need further treatment.There patients with postoperative subtalar traumatic arthritis,patients are asymptomatic,at end no further treatment.All patients with no wound complications and no neurovascular injury.Conclusion Closed reduction and percutaneous screw fixation for talar neck fractures can obtain excellent clinical results,but should be selecting the appropriate patients,and Computed Tomography must be used to ensure satisfactory reduction.
