A Treatment of Fracture of the Neck of the Talus

Oh, In Suk; Moon, Do Hyun; Ko, Jin Hong; Kang, Ki Dong; Kim, Si Hwan

Abstract

A fracture of the tatar nock if relatively rare, but it is generally regarded as a serious traumatic lesion of the ankle, because of the poor outcome after treatment. The talus has a special anatomical, functional and vascular characteristics. So the complications with avascular necrosis and nonunion and degenerative joint diseases are frequent. We reviewed 19 cases who treated at ChungAng Gil General Hospitai from January, 1990 to August, 1994 and studied the incidence of complications and important factors in achieving good results. The follow up period was at least 12 months. The results were as follows; 1. Of the 18 cases, there were 18 males and 2 females, and most were third and fourth decades(67%). 2. The main cause were a fall down injury(44%), with sudden hyperextension as its mechanism. 3. According to Hawkins classification, type I, type II & type III were 6,8 & 4 cases, respectively. 4. The accompanying ipsilateral peri-ankle involvement were observed in 44%. 5. As for the method of treatment, C/R with cast immobilization were performed in 6 cases of type I while O/R and I/F with screw & Steinmann pin done on others. 6. As for the complications, AVN, skin necrosis, traumatic arthritis and infection were 3, 1,2 and 1 cases, respectively. : Excellent in 9 cases, good in 6, fair in 1, poor in 2. Consequently we think, in the treatment of displaced neck fracture and dislocation of talus, it is important to decompress the soft tissue early with concomitant anatomical reduction & internal fixation to get a satisfactory results.