OUTCOMES OF OPEN REDUCTION AND INTERNAL FIXATION OF FRACTURE OF NECK OF TALUS

  • Muhammad Zafar Iqbal Shahid Services Institute of Medical Sciences, Services Hospital, Lahore
  • Muhammad Khalid Postgraduate Medical Institute / Ameer-ud-Din Medical College,/Lahore General Hospital, Lahore
  • Tanveer Haider Khawaja Safdar Medical College, Sialkot
  • Asim Islam Services Institute of Medical Sciences, Services Hospital, Lahore
Keywords: fracture, neck of talus

Abstract

Background: Talus is the second largest tarsal bone with unique importance regarding its location and anatomy . It is an osseous link between foot and the leg and has got a pivotal role in overall foot function . It has got three important articulations at tibiotalar , talocalcaneal and talonavicular joint . It is divided into body , neck and posterior facets. Almost 70% surface of talus is covered with articular cartilage . Its blood supply is predominantly extraosseous and is at risk during fractures .

Objectives : The aim of our study is to observe the long term outcomes after surgical treatment of fracture neck of talus .

Study design  : Prospective cross sectional study .

Study setting :  Department of Orthopedic Surgery Services hospital , Lahore

Study duration :  From Dec 2017 – Feb 2020

Methodology: After approval from hospital ethical review board , total number of 30 patients with fracture neck of talus , both males ( 20 patients ) and females ( 10 patients ) were included in the study . Each patient underwent X-rays of ankle joint AP , LAT and ankle mortis views .. All these fractures were fixed with 4 mm cannulated screw by using combined anterolateral and anteromedial approach.

Results:   Post-traumatic arthritis was observed in 15 patients (50.0%) out of the 30 patients with 10 (75.0 %) patients at subtalar joint and 5 (25.0 %) patients at ankle joint. Among these 30 patients , 8 (26.7%)  patients were having Hawkins type 2 , 14 (46.6%)   with Hawkins type 3 and remaining 8 (26.7%) patients with were having Hawkins type 4 fractures. Osteonecrosis was mostly observed in Hawkins type 3 fractures 6 (42.8%)   in Hawkins type 3, 2 (25.0%)    patients in Hawkins type 2 fractures and 1 (12.5%)  patient in Hawkins type 4 fractures. 1 (3.3 %) patient developed non-union and 1 (3.3 %) patient developed delayed union. 4(13.3 %) patients developed the superficial infection which was treated with IV antibiotics and wound irrigation .

Conclusion: We concluded from our study that familiarity with the complex vascular , bony , surgical anatomy and techniques for rigid fixation of fractures is of utmost importance for fracture neck of talus . Rate of osteonecrosis , arthritis , mal-union and non-union are still high even in the presence of rigid internal fixation of these fractures

Author Biographies

Muhammad Zafar Iqbal Shahid, Services Institute of Medical Sciences, Services Hospital, Lahore

Associate Professor, Department of Orthopedics

Muhammad Khalid, Postgraduate Medical Institute / Ameer-ud-Din Medical College,/Lahore General Hospital, Lahore

Assistant Professor, Department of Orthopedics

Tanveer Haider, Khawaja Safdar Medical College, Sialkot

Department of Orthopedic Surgery

Asim Islam, Services Institute of Medical Sciences, Services Hospital, Lahore

Department of Orthopedic Surgery

Published
2022-11-12