Secondary anatomical reconstruction of malunited central talus fractures

作者：Zwipp H^*; Gavlik M; Rammelt S

来源：Unfallchirurg, 2014, 117(9): 767-+.

DOI：10.1007/s00113-014-2601-8

• Joint incongruence
• Fracture
• Malunion
• Nonunion
• Osteotomy

Malunion or nonunion of central talar fractures lead to significant impairment, pain and decreased motion of the foot and ankle. In a 20-year period from 1994 to 2013 at the Trauma Department of the University Hospital"Carl Gustav Carus" of the Technical University of Dresden we treated a total of 25 patients with secondary anatomical reconstruction of the talus.
The mean age of the patients was 39.9 years (range 15-71 years) and only 4 out of the 25 patients were female. Of these patients 11 patients were treated conservatively, 3 minimally invasive with external fixation and were admitted on average 7.6 months (range 1.5-42 months) after the initial fracture. Of the patients 11 had previously been treated in another hospital by open surgery on average 8.4 months (range1-24 months) months before. There were 9 malunions or nonunions of talar fractures of the shaft, 14 of the neck and 2 of the head. Only 3 cases were old fractures a parts per thousand yen 6 weeks and 22 were malunions or nonunions a parts per thousand yen 3 months. According to an in-house classification 12 malunions (type I), 5 nonunions (type II), and 8 malunions/nonunions with partial necrosis (type III) were treated.
Of the patients 21 out of 25 needed a bilateral approach and 6 additionally an osteotomy of the medial malleolus.The mean follow-up of 22 out of 25 patients was 5.4 years (range1.0-21.5 years). The preoperative American Orthopedic Foot and Ankle Society (AOFAS) hindfoot score increased on average from 36.6 to 86.7 points (p < 0.001) at the time of follow-up.

• 出版日期2014-9