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Long-term follow-up after surgical treatment of talar fractures: Twenty cases with an average follow-up of 7.5 years

机译:距骨骨折手术治疗后的长期随访:20例,平均随访7.5年

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摘要

Displaced talar neck and body fractures are rare and serious injuries with important outcomes. The aim of our study was to evaluate the long-term outcomes of these fractures after operative treatment in our centre between 1993 and 2005. Displaced talar fractures have a high rate of long-term complications. This was a retrospective study concerning 20 patients with an average follow-up of 7.5 years. The final follow-up examination included determination of the AHS score (ankle–hindfoot scale) from the American Orthopaedic Foot and Ankle Society (AOFAS), range of motion evaluation and radiological analysis. Mean age at the time of trauma was 38.8 years. This study comprised ten talar neck fractures and ten talar body fractures. We always used a single surgical approach and obtained anatomical reduction in 30% of the whole series of both groups. Four early complications were noted in four patients (20%). We noted no skin complications and the rate of consolidation was 100%. Four patients (20%) developed avascular necrosis of the talus, and at final follow-up seven patients (35%) had undergone secondary surgery. Radiographic analysis showed an osteoarthritis rate of 94% and a malunion rate of 59%. The mean AOFAS score was 66.9/100 and range of motion was systematically decreased. Contrary to undisplaced talar fractures, displaced talar fractures are a therapeutic challenge with many early or late complications. The outcome often revealed stiffness and osteoarthritis.
机译:距骨脖子和身体移位很少见,严重的人受伤有重要的后果。我们研究的目的是评估1993年至2005年间在我们中心进行手术治疗后这些骨折的长期预后。距骨骨折长期并发症的发生率很高。这是一项回顾性研究,涉及20例患者,平均随访时间为7.5年。最终的随访检查包括由美国骨科足踝协会(AOFAS)确定AHS评分(踝-后脚尺),运动评估范围和影像学分析。受伤时的平均年龄为38.8岁。这项研究包括十个距骨颈部骨折和十个距骨身体骨折。我们一直使用单一的手术方法,并且在两组的整个系列中均获得了30%的解剖复位。在四名患者中发现了四个早期并发症(20%)。我们注意到没有皮肤并发症,巩固率为100%。四名患者(20%)发生了距骨的血管坏死,在最后的随访中有七名患者(35%)接受了二次手术。影像学分析显示骨关节炎发生率为94%,畸形畸形发生率为59%。平均AOFAS评分为66.9 / 100,运动范围被系统性降低。与未移位的距骨骨折相反,移位的距骨骨折是具有许多早期或晚期并发症的治疗挑战。结果通常显示出僵硬和骨关节炎。

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