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Screw Fixation Techniques for Talar Neck Fractures (Anterior versus Posterior insertion)  

Shin, Dong-Eun (Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University)
Yoon, Hyung-Ku (Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University)
Choi, Woo-Jin (Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University)
Lee, Yoon-Seok (Department of Orthopaedic Surgery, CHA Gumi Medical Center, CHA university)
Han, Seung-Chul (Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University)
Publication Information
Journal of Korean Foot and Ankle Society / v.14, no.1, 2010 , pp. 79-83 More about this Journal
Abstract
Purpose: To compare the clinical and radiological results between the anterior and posterior screw fixation for the treatment of talar neck fracture. Materials and Methods: Among 30 patients who received surgical treatment for talar neck fracture from 2001 to 2008. Twenty-seven patients with a follow-up period of more than 1 year were divided into two groups. Twelve patients were treated with anterior screw fixation and 15 patients with posterior approaches. We analyzed preoperative, postoperative and follow-up radiographs. Clinical results were evaluated by Hawkins criteria. Results: The posteriorly inserted screws were placed across the more central portion of the talar neck and perpendicular to the plane of fracture (p<0.05). There were no difference in clinical results, the duration of union, and complications including avascular necrosis between two groups. However, 2 patients complained of pain around the talonavicular joint in the anterior insertion group. Conclusion: Although the clinical results were good irrespective of insertion methods, the posterior approach of screw fixation for talar neck fractures allows for a better mechanical advantage than anterioly placed screws. This may allow early motion with a reduced risk of failure of fixation or of displacement of the fracture.
Keywords
Talus; Neck fracture; Anterior and posterior approach; Screw fixation;
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1 Attiah M, Sanders D, Valdivia G. Comminuted talar neck fractures: a mechanical comparison of fixation techniques. J Orthop Trauma. 2007;21:47-51.   DOI   ScienceOn
2 Metzqer MJ, Levin JS, CIancy JT. Talar neck fractures and rates of avascular necrosis. J Foot Ankle Surg. 1999;38: 154-62.   DOI   ScienceOn
3 Mayo KA. Fractures of the talus: principles of management and techniques of treatment. Tech Orthop. 1987;30:45-52.
4 Penny JN, Davis LA. Fractures and fracture-dislocations of the neck of the talus. J Trauma. 1980;20:1029-37 .   DOI   ScienceOn
5 Szyszkowitz R, Reschauer R. Eighty-five talus fractures treated by ORIF with five to eight years of follow-up study of 69 patients. Clin Orthop. 1985;199:97-107.
6 Ebraheim N, Mekhail A, Salpietro B, Mermer M, Jackson W. Talar neck fractures: anatomic considerations for posterior screw application. Foot Ankle Int. 1996;17:541-7.   DOI   ScienceOn
7 Kenwright J, Taylor RG. Major irifuries of the talus. J Bone Joint Surg. 1970;52:36-48.
8 Trillat A, Bousquet G, Lapeyre B. Displaced fractures of the neck or of the body of the talus. Value of screwing by posterior surgical approach. Rev chir orthop. 1970;56:529-36.
9 Grub D, Simpson LA, Weber BG, Bray T. Operative treatment of displaced talus fractures. Clin Orthop. 1985;199:88-96.
10 Sangeorzan B, Ananthakrishnan D, Tencer A. Contact characteristics of the subtalar joint after a simulated calcaneus fracture. J Orthop Trauma. 1995;9:251-8 .
11 Swanson T, Bray T, Holmes G. Fractures of the talar neck. A mechanical study of fixation. J bone Joint Surg. 1992;74: 544-51.
12 Hawkins L. Fractures of the neck of the talus. J bone Joint Surg.1970;52:991-1002.
13 Fortin PT, Balazsy JE. Talus fractures: evaluation and treatment. J Am Acad Orthop Surg. 2001;9:114-27.
14 Pajenda G, Vecsel V, Reddy B, Heinz T. Treatment of talar neck fractures: clinical results of 50 patients. J Foot Ankle Surg.2000;39:365-75.   DOI   ScienceOn
15 DeLee JC. Fractures and dislocations of the foot. In: Mann RA. ed, St. Louis: C. V. Mosby; 1984. 656-83.
16 Lemaire R, Bustin W. Screw fixation of fractures of the neck of the talus using a posterior approach. J Trauma. 1980;20: 669-73 .   DOI   ScienceOn
17 Canale ST, Kelly F. Fractures of the neck of the talus. Long-term evaluation of seventy-one cases. J bone Joint Surg. 1978;60:143-56.