title: Talar Neck Fractures Treated Using a Highly Selective Incision: A Case-Control Study and Review of the Literature.
abstract: We describe a highly selective incision combined with percutaneous manipulation for reduction and internal fixation of talar neck fractures. We retrospectively investigated the clinical data from 29 cases of talar neck fractures treated from January 2009 to June 2013. Fifteen patients (study group) were treated using a 1- to 2-cm limited incision placed on the anteromedial or anterolateral side of the talus, followed by percutaneous reduction and fixation. Another 14 patients (control group) underwent open reduction and internal fixation through a conventional anteromedial or anterolateral approach. All cases were fixed with Herbert screws or cannulated titanium screws. All the patients were followed up for a minimum of 18 (median 24) months. All the fractures displayed bony union at or before the final follow-up visit. The mean American Orthopaedic Foot and Ankle Society ankle scale score in the study group was 75.3 ± 17.7, 9 patients (60%) had good or excellent results, and 3 (20%) developed talar avascular necrosis. The mean ankle scale score in the control group was 78.9 ± 15.2, 9 patients (64.3%) had good to excellent results, and 6 (42.9%) developed avascular necrosis. No statistically significant differences were found in the American Orthopaedic Foot and Ankle Society score, the number of good to excellent outcomes, or the incidence of complications between the incision groups. A highly selective incision combined with percutaneous reduction and internal fixation can be used to treat fractures of the neck of the talus satisfactorily.
authors.affiliation: Orthopaedist, Department of Trauma Orthopaedics, Shanghai General Hospital Affiliated to Jiaotong University, Shanghai, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Wu
authors.affiliation: Assistant Professor, Department of Orthopaedics, Shanghai General Hospital Affiliated to Jiaotong University, Shanghai, China.
authors.forename: Zihui
authors.initials: Z
authors.lastname: Zhou
authors.affiliation: Assistant Professor, Department of Trauma Orthopaedics, Shanghai General Hospital Affiliated to Jiaotong University, Shanghai, China.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Huang
authors.affiliation: Orthopaedist, Department of Trauma Orthopaedics, Shanghai General Hospital Affiliated to Jiaotong University, Shanghai, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Lin
authors.affiliation: Professor, Department of Trauma Orthopaedics, Shanghai General Hospital Affiliated to Jiaotong University, Shanghai, China. Electronic address: m13501733652@163.com.
authors.forename: Qiugen
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Professor, Department of Orthopaedics, Shanghai General Hospital Affiliated to Jiaotong University, Shanghai, China. Electronic address: callvin_woo@medmail.com.cn.
authors.forename: Jie
authors.initials: J
authors.lastname: Tao
mesh_terms: D000328:Adult; D001863:Bone Screws; D016022:Case-Control Studies; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D011183:Postoperative Complications; D013628:Talus / Q000293:injuries* / Q000601:surgery
keywords: avascular necrosis; fracture; incision; injury; talus; trauma