Complications after talus fractures: A trauma centre experience |
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| Affiliation: | 1. Serviço de Ortopedia e Traumatologia Prof. Nova Monteiro, Hospital Municipal Miguel Couto, Rio de Janeiro, RJ, Brazil;2. St. Joseph University, Dept. of Orthopedic Surgery, Hotel Dieu de France Hospital, Alfred Naccache Blvd, Beirut, Lebanon;3. University of Calgary, 0490 McCaig Tower, Foothills Hospital, 3134 Hospital Drive NW Calgary, Alberta T2N 5A1, Canada;1. Department of Orthopaedics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, 610041 Sichuan, China;1. Department of Mechanical Engineering, University of Zaragoza, Zaragoza, Spain;2. Department of Orthopaedic Surgery and Traumatology, Lozano Blesa University Hospital, Zaragoza, Spain;3. Aragón Health Research Institute, Zaragoza, Spain;4. Department of Surgery, University of Zaragoza, Zaragoza, Spain;5. Aragón Institute for Engineering Research, Zaragoza, Spain;1. Department of Orthopedics and Traumatology, Beijing Jishuitan Hospital, Beijing 100035, China;2. School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China;3. Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing 100083, China;4. Rossum Robot Co., Ltd., Beijing 100083, China;1. Department of Orthopaedic Surgery and Rehabilitation, University of Mississippi Medical Center, 2500 N State Street, Jackson, MS, 39216 |
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| Abstract: | ![]()
BackgroundTalus fractures are anatomically complex, high-energy injuries that can be associated with poor outcomes and high complication rates. Complications include non-union, avascular necrosis (AVN) and post-traumatic osteoarthritis (OA). The aim of this study was to analyse the outcomes of these injuries in a large series.MethodsWe retrospectively collected data on 100 consecutive patients presenting to a single high volume major trauma centre with a talus fracture between March 2012 and March 2020. All patients were over the age of 18 with a minimum of 12 months follow up post injury. Retrospective review of case notes and imaging was conducted to collate demographic data and to classify fracture morphology. Whether patients were managed non-operatively or operatively was noted and where used, the type of operative fixation, outcomes and complications were recorded.ResultsThe mean age was 35 years (range: 18–76 years). Open injuries accounted for 22% of patients. An isolated talar body fracture was the most frequent fracture (47%), followed by neck fractures (20%). The overall non-union rate was 2% with both cases occurring in patients with open fractures. The AVN rate was 6%, with the highest prevalence in talar neck fractures. Overall rates of post-traumatic OA of the tibio-talar, sub-talar and talo-navicular joints were 12%, 8%, and 6%, respectively. These were higher after a joint dislocation, and higher in neck or head fractures. The postoperative infection rate was 6%. The overall secondary surgery rate was 9%. There were 2% of patients who subsequently underwent a joint arthrodesis.ConclusionOur study found that talar body fractures are more common than previously reported; however, talar neck fractures cause the highest rates of AVN and post-traumatic arthritis. Open fractures also carry a greater risk of complications. This information is useful during consenting and preoperatively when planning these cases to ensure adverse outcomes may be anticipated. |
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