Abstract

MACKLIN VADELL, Alberto et al. Fracturas graves del cuello del astrágalo. Análisis del tratamiento en 20 casos. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2022, vol.87, n.1, pp.15-22. ISSN 1852-7434.  http://dx.doi.org/https://doi.org/10.15417/issn.1852-7434.2022.87.1.1357.

Introduction: Talar neck fractures are rare but present a high rate of complications and reoperations. The objective of this work was to analyze and describe the complications in the medium and long term in 20 patients with talar neck fracture. Our hypothesis was that, in severe injuries, ORIF presents a high rate of complications that will require new surgical interventions. Materials and Methods: We evaluated 20 patients with talar neck fracture: 6 Hawkins II (29%), 11 Hawkins III (52%), and 3 Hawkins IV (19%). The mean follow-up was 11 years. We analyzed the fracture pattern (simple or comminuted), the presence of associated injuries, complications, and the need to perform a new surgical procedure. Results: 11 (55%) had associated injuries and 14 (70%) had comminution in the fracture line. We presented complications in 15 patients (75%). 9 (45%) patients required a second intervention to treat the complication. Conclusions: The factors most related to the development of complications and the need for a new intervention are: comminution in the fracture line, associated injuries in the ipsilateral lower limb, Hawkins type III and IV fractures, and exposed fractures. We believe that in severe talar neck injuries (Hawkins type III and IV) with one or more of these factors, primary arthrodesis reduces the risk of complications and new surgeries and shortens recovery time.

Keywords : Talar neck fractures; treatment; outcomes.

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