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EVALUATION AND TREATMENT OF TALAR FRACTURES

A.X.Papadopoulos, M.Tyllianakis, E. Lambiris Orthopeadic Department of Patras University Head: Prof. E. Lambiris ORTHO PATRAS


TALAR FRACTURES: 3% of all foot fractures Dorsiflexion (extension) is the main mechanism of injury Arthritis is common: 70% of talus surface is covered by cartilage

High likelihood of vascular interruption

ORTHO PATRAS


PATIENTS Between 1992 and 2000, 25 patients with talus fractures were treated

Follow-up: 23 patients [20 men-3 women] Mean age 31,8 y (16 - 64 y) 12 (52,2%) multi-injured patients

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ΜΗΧΑΝΙΣΜΟΣ ΚΑΚΩΣΗΣ 8

34,7% 65,2%

15

Τροχαίο ατύχημα Πτώση από ύψος

ORTHO PATRAS


CLASSIFICATION: Talar neck fracture 15 patients (65,2%)

A

C

B

D

(Hawkins 1970 - Canale and Kelly’s modification 1978)


Talar body fracture(shearing) : 4 patients (17,4%) Talar head fracture: 1 patient

Talar process fracture :3 patients (13,1%)-posterior tubercle

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RADIOLOGICAL EVALUATION Foot-Ankle F+P

Foot-Ankle in 15% inversion

Talus CT (saggital,tranverse and coronal)

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TREATMENT Surgical treatment : 18 patients

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RESULTS Mean folow-up : 58 months (12 months - 9 years) Excellent: 11 patients (47,8%)

Good: (21,7%)

5 patients

Moderate: 3 patients (16,6%) Poor: (17,4%)

4 patients

Iowa Ankle evaluation score FUNCTION (40)

FREEDOM FROM PAIN (40) GAIT (10) RANGE OF MOTION (10) SUMMARY (100) ORTHO PATRAS


NECK # RESULTS

5

excellent good

1

2

1

1 A B C D

1

2

moderate poor 0%

20%

40%

60%

80%

100% ORTHO PATRAS


BODY-PROCESS-HEAD # RESULTS

excellent

2

good

1

moderate

1

poor 0%

body process

1 20%

1 40%

60%

80% 100% ORTHO PATRAS


COMPLICATIONS Arthritis Subtalar: 6 patients Ankle:

2 patients

Avascular necrosis: 1 patient

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Α.H. 19 years old, neck # type A and posterior tubercle #

3/12 PO

6 /12 PO ORTHO PATRAS


Κ.D. 64 y neck # type D

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Κ.D. PO

3 years PO

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P.T. 31y body #

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P.T. 1,5 y PO ankle arthritis-arthrodesis

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P.N. 25y, head # 4y PO

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H.B. 59y, neck # type B

1,5 m PO

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H.B. 5m PO

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CONCLUSION Immediated anatomical reduction with internal fixation is essential for good results after talus fractures Undisplaced talus fractures can be treared conservatively by immobilization and close observation Internal fixation using Herbert screw may be a good alternative solution ORTHO PATRAS

Κατάγματα Αστραγάλου  

Κατάγματα Αστραγάλου

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