[Surgical treatment of open fractures of the talus].
OBJECTIVE
To evaluate the long-term outcomes of surgical treatment of open fracture of talus.


METHODS
Sixteen patients with displaced open fractures of the talus, including 3 cases of type 1, 8 of type 2, 2 of type 3A, 2 of type 3B, and 1 of type 3C according to the Gustilo-Anderson classification system, 15 males and 1 female, aged 37.5 (21 - 48), were treated with open reduction and stable internal fixation within 6 - 8 hours after injury, and followed up for 3.2 years (3 - 6 years). There were 7 cases of pure displaced talar neck or body fracture and 9 cases of fractures associated with an ipsilateral pilon, ankle, and calcaneus totally that included 2 cases of type 2, 3 of type 3, and 1 of type 4 according to the Hawkins classification system modified by Canale.


RESULTS
The union rate was 81% (13/16) with the average union time of 4.5 months. Three cases failed to heal and developed osteomyelitis, of which 2 were treated with late talectomy because of septic nonunion. One case underwent amputation below-the-knee because of instability and pain. Osteonecrosis developed after seven of the nineteen closed fractures, whereas posttraumatic arthritis developed after all nineteen. Osteonecrosis developed in 11 (68%), and posttraumatic arthritis developed in 13 of the 16 cases (85%). The average American Orthopaedic Foot and Ankle Society score of these patients was 43.7 points.


CONCLUSIONS
Open fractures of the talus has a low union rate, a higher osteonecrosis rate, and substantially higher reoperation and infection rates. Posttraumatic arthritis is a more common complication than osteonecrosis following operative treatment. Open reduction and internal fixation are recommended for the treatment of open fractures of talus.
Fang
Li-ming
LM
Second Hospital of Chinese People's Armed Police Force, Beijing 100037, China.
Wang
Jun-qiang
JQ
Zhang
Jun
J
Zheng
Ji-yuan
JY
Zhang
Shu-xi
SX
Wang
Yan
Y
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013628:Talus / Q000293:injuries*; D016896:Treatment Outcome