title: Prevention of avascular necrosis in displaced talar neck fractures by hyperbaric oxygenation therapy: a dual case report.
abstract: Talar neck fractures are a rare injury that account for less then 2% of all foot fractures. Displaced fractures are associated with an exceedingly high rate of avascular necrosis (AVN). The incidence of AVN following Hawkins Type 3 fractures of the talar neck may approach 100%, particularly if diagnosis and reduction are delayed. Severe cases may present as pain and disability of the ankle and the subtalar joints due to a talar dome collapse, resulting in degenerative changes that usually require hind foot arthrodesis. We present two cases of traumatic displaced talar neck fractures which were treated surgically more than 2 weeks following injury due to a delay in diagnosis. Both patients underwent hyperbaric oxygen therapy (HBOT) after the operation and neither resulted in AVN of the talus in a three-year follow-up. We suggest that this favorable result may be due to the beneficial effects of HBOT.
authors.affiliation: Department of Orthopedics, Meir University Hospital, Sapir Medical Center, Kfar Saba, Israel. omer@extremegate.com
authors.forename: O
authors.initials: O
authors.lastname: Mei-Dan
authors.forename: I
authors.initials: I
authors.lastname: Hetsroni
authors.forename: G
authors.initials: G
authors.lastname: Mann
authors.forename: Y
authors.initials: Y
authors.lastname: Melamed
authors.forename: M
authors.initials: M
authors.lastname: Nyska
mesh_terms: D000328:Adult; D016512:Ankle Injuries / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D010020:Osteonecrosis / Q000209:etiology / Q000517:prevention & control*; D013380:Subtalar Joint / Q000293:injuries* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome