Fracture - Dislocation of the Talus

Suh, Jeung Tak; Suh, Yong Ho; Yoo, Chong Il

Abstract

The talus is one of the most important bones of the foot because it supports and distributes body weight above it and allows motion between the tibia and the foot. And it has unique biomechanical feature and vascular supply. Fractures and dislocations of talus are uncommon. However, once those happen, there is no single method of treatment and, all the more, there are several severe complications and are subsequent disabililies. Authors analyzed 15 cases of fracture-dislocation of the talus, which had been treated at Pusan National University Hospital from May 1988 to December 1994. 1. Among the 15 cases, there were 13 male and 2 female and the average age was 28.4 ranged from 6 to 48. 2. The causes were traffic accidents in 11, failing down in 4 cases. A violent hyperdorsiflexion of the ankle was common mechanism of the fracture. 3. According to the classification by Hawkins, there were 9 cases in talar neck fracture(2 cases in type I, 3 in type II, 4 in type III), 1 was head fracture and 5 were body fractures. 4. Two cases of talar neck fracture type I were treated conservatively, and other types were treated operatively. 5. Final results, evaluated by the criteria of Hawkins, were as follows : excellent in 3 cases, good in 7, fair in 4 and poor in one. 6. Complications were avascular necrosis in 4 cases and traumatic arthritis in 3 cases. According to the results, talar neck fracture associated with marked displacement, comminution of subtalar joint and dislocation increased the rate of occurrence of complications despite of early open reduction and internal fixation.