J Korean Foot Ankle Soc.  2010 Jun;14(1):79-83.

Screw Fixation Techniques for Talar Neck Fractures (Anterior versus Posterior insertion)

• Shin DE
• Yoon HK
• Choi WJ
• Lee YS
• Han SC

Abstract

PURPOSE
To compare the clinical and radiological results between the anterior and posterior screw fixation for the treatment of talar neck fracture.
MATERIALS AND METHODS
Among 30 patients who received surgical treatment for talar neck fracture from 2001 to 2008. Twenty-seven patients with a follow-up period of more than 1 year were divided into two groups. Twelve patients were treated with anterior screw fixation and 15 patients with posterior approaches. We analyzed preoperative, postoperative and follow-up radiographs. Clinical results were evaluated by Hawkins criteria.
RESULTS
The posteriorly inserted screws were placed across the more central portion of the talar neck and perpendicular to the plane of fracture (p<0.05). There were no difference in clinical results, the duration of union, and complications including avascular necrosis between two groups. However, 2 patients complained of pain around the talonavicular joint in the anterior insertion group.
CONCLUSION
Although the clinical results were good irrespective of insertion methods, the posterior approach of screw fixation for talar neck fractures allows for a better mechanical advantage than anterioly placed screws. This may allow early motion with a reduced risk of failure of fixation or of displacement of the fracture.

Keyword

Talus; Neck fracture; Anterior and posterior approach; Screw fixation

MeSH Terms

Displacement (Psychology)
Follow-Up Studies
Humans
Imidazoles
Joints
Neck
Necrosis
Nitro Compounds
Talus
Imidazoles
Nitro Compounds