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Fracture of the Body of the Talus
Authors:O. Sneppen   S. Bach Christensen  O. Krogs  e  J. Lorentzen
Affiliation: a Department of Orthopaedic Surgery U, Rigshospitalet, The Directorate of Employment Accident Insurance, Copenhagen, Denmark
Abstract:Fifty-one patients with fracture of the body of the talus were seen at follow-up examination an average of 23 months after treatment. Osteonecrosis had developed in 8 out of 17 patients with displaced shearing or crush fractures of the trochlea. Malunion as well as subluxation predisposed to osteoarthrosis in the subtalar and talocrural joints. Thus, osteoarthrosis was present in 9 out of 21 patients without malunion, in 8 out of 16 patients with malunion, and in 11 out of 14 with malunion as well as subluxation. Judging from the nature of the complaints, the difficulties in rehabilitation, and the disability assessment, the prognosis was fairly grave, also after the small, usually non-displaced fractures of the posterior and lateral tubercles. Out of 20 patients with fractures of this type only 6 obtained almost complete relief from their symptoms, only 8 could go back to their previous work on a full-time basis, and 11 were assessed to be 10 per cent or more disabled. Fractures in the posterior and lateral tubercles must therefore be interpreted as links in more extensive injuries involving the subtalar joint and possibly the talocrural joint with associated injuries to articular cartilage, joint capsules, and ligaments.
Keywords:talus  fracture  osteoarthrosis  osteonecrosis  avascular necrosis
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