title: Complications of talus fractures in children.
abstract: BACKGROUND
  Pediatric talus fractures are rare with variable rates of posttraumatic complications reported in the literature. The purpose of this retrospective study was to evaluate posttraumatic complications in children after talus fracture and report injury characteristics.
  
  
  METHODS
  This study included 29 children with talus fractures sustained between 1999 and 2008 at an average age of 13.5 years (range, 1.2-17.8). Patient records and radiographs were reviewed to determine the mechanism of injury, fracture type, associated injuries, and treatment. Posttraumatic complications assessed were avascular necrosis, arthrosis, nonunion or delayed union, neurapraxia, infection or wound-healing problems, and the need for further unanticipated surgery. Clinical follow-up averaged 24 months (range, 6 mo-5 y).
  
  
  RESULTS
  Twenty-nine children sustained a major fracture of the talar body, neck, or head. Avascular necrosis occurred in 2 patients (7%), arthrosis in 5 (17%), delayed union in 1 (3%), neurapraxia in 2 (7%), infection in 0, and the need for further surgery in 3 (10%). Both high-energy mechanism and fracture displacement corresponded to a greater number of posttraumatic complications. The number and severity of talus fractures increased in older children.
  
  
  CONCLUSIONS
  In this case series, posttraumatic complications after pediatric talus fractures occurred more frequently after a high-energy mechanism of injury or a displaced fracture. Talus fractures occurred more commonly and with more severity in older children.
  
  
  METHODS
  Level IV. Retrospective case series.
authors.affiliation: Department of Orthopaedics, Children's Hospital Boston, Boston, MA, USA. jsmith42@partners.org
authors.forename: Jeremy T
authors.initials: JT
authors.lastname: Smith
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Curtis
authors.forename: Samantha
authors.initials: S
authors.lastname: Spencer
authors.forename: James R
authors.initials: JR
authors.lastname: Kasser
authors.forename: Susan T
authors.initials: ST
authors.lastname: Mahan
mesh_terms: D000293:Adolescent; D001847:Bone Diseases / Q000453:epidemiology / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D050723:Fractures, Bone / Q000145:classification / Q000150:complications* / Q000628:therapy; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013628:Talus / Q000293:injuries*; D014949:Wounds, Nonpenetrating / Q000145:classification / Q000150:complications* / Q000628:therapy