The avascular necrosis after talar neck fractures. Risk factors and Outcomes | ||||
| Journal of Current Medical Research and Practice | ||||
| Volume 6, Issue 4, October 2021, Page 340-345 PDF (390.6 K) | ||||
| DOI: 10.4103/JCMRP.JCMRP_33_20 | ||||
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| Authors | ||||
| Lokas S. Asham; Amr A. Elfadle; Mahmoud Badran; Aly M. Mohamed; Osama A. Farouk | ||||
| Abstract | ||||
| Background The incidence of talar fractures is less than 1.0% of all fractures. Fractures of the talar neck and body are often due to high-energy trauma such as motor vehicle accident or falls from height. The purpose of the present study is to evaluate the effect of different factors, including fracture type, skin condition, surgical delay, quality of fracture reduction, and surgical approach, on the incidence of osteonecrosis after talar neck fractures and to determine the functional outcomes after osteonecrosis. Patients and methods This study is a single center prospective case series of 64 patients of talar neck fracture. 50 patients who were included in this study, were evaluated and treated at the Department of orthopedics, Assuit university hospital during 1 / 2016 to 8 /2018. While there were 14 cases were excluded. The final results were assessed using American Orthopaedic Foot and Ankle Society score (AOFAS). Results Osteonecrosis was associated with the degree of fracture-dislocation and fracture comminution ( < 0.001) and bad skin condition ( < 0.001). Osteonecrosis was associated with the quality of fracture reduction ( = 0.003). There was a significant correlation between the development of osteonecrosis and the surgical approach ( = 0.013). Osteonecrosis statistically affected the final functional outcome according to American Orthopedic Foot and Ankle Society score ( < 0.001). Conclusion Osteonecrosis was associated with degree of fracture, fracture-dislocation, and bad skin condition, confirming that higher-energy injuries are associated with more complications and a worse prognosis. However, no correlation was found between the timing of fixation and the development of osteonecrosis. Moreover, osteonecrosis was associated with quality of reduction and surgical approach. We recommend urgent reduction of dislocations and soft-tissue care. Proceeding with definitive rigid internal fixation of talar neck fractures after soft-tissue swelling has subsided may minimize complications. | ||||
| Keywords | ||||
| Talar neck fractures; Osteonecrosis; AOFAS | ||||
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