[Treatment strategy for talus fractures].
Fractures of the talus are uncommon, but they present difficult treatment challenges. The classifications of fractures are based on conventional X-rays, but the CT scan is necessary for treatment decisions. Open fractures, displaced fracture dislocations, or extrusion of the talus must be reduced and stabilized as an emergency procedure. In all cases of displaced fractures, ORIF is indicated. The use of standardized approaches depends on the type of fracture and the soft tissue lesion. Precise anatomic reduction of all facets and reconstruction of the shape of the talus and stabilization with interfragmentary lag screws is the method of choice in almost all fractures. This procedure allows early mobilization postoperatively. The outcome is related to the degree of fracture displacement and the soft tissue lesion but may be poor due to inadequate treatment. Talus malunion, nonunion, and secondary deformity should be corrected early with preservation of the joints whenever possible. Arthrodeses should be restricted to the affected joints.
Sektion Fuss- und Sprunggelenkchirurgie, Klinik für Unfall-, Wiederherstellungschirurgie und Orthopädie, Zentrum für Muskuloskeletale Chirurgie, Charité--Universitätsmedizin Berlin. dan-henrik.boack@charite.de
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D016512:Ankle Injuries / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D001174:Arthrodesis; D001863:Bone Screws; D005593:Fracture Fixation, Internal; D017102:Fracture Healing / Q000502:physiology; D050723:Fractures, Bone / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D004204:Joint Dislocations / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000601:surgery; D012680:Sensitivity and Specificity; D017695:Soft Tissue Injuries / Q000000981:diagnostic imaging / Q000601:surgery; D013628:Talus / Q000000981:diagnostic imaging / Q000293:injuries*; D014057:Tomography, X-Ray Computed