Impact of Weight Bearing Surface on Fractures of the Talus

Chung, Hyun Wook; Yoo, Si Hoon; Suh, Jin Soo

Abstract

PURPOSE
The fracture of talus has critical complications and results in various clinical outcomes. The purpose of this study is to evaluate clinical outcome and influence on involvement of ankle and subtalar joint.
MATERIALS AND METHODS
From December 1999 to December 2008, a total of 66 fractures and dislocations of talus was treated with minimal 9 months follow up period. Ankle-hindfoot scale of the American Orthopedic Foot& Ankle Society (AOFAS) was used to evaluate the clinical outcome. The complications and sequential radiologic findings were also analyzed.
RESULTS
There were 28 neck fractures, 11 lateral process fractures, 10 body fractures, 7 osteochondral fractures, 4 posteromedial tubercle fractures and 4 medial process fractures. In 38 cases, there were concomitant injuries. Ipsilateral ankle fracture, which found in 19 cases, was most common. The surgical treatment was performed in 36 cases. Mean AOFAS score was 85.5 (range, 72 to 96). In 13 of 47 cases, one or more fracture lines involving weight bearing surface were confirmed. The involvement of ankle or subtalar joint had resulted in unsatisfied outcome. Complications were developed as follows, post-traumatic arthritis in 8 cases, avascular necrosis in 3 cases, and deep infection in 2 cases.
CONCLUSION
The involvement of ankle or subtalar joint in fractures of talus seemed to be common and to impact the clinical outcome. Meticulous consideration about that will be positively necessary.