Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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Clinical Outcomes of Anterior Open Reduction and Posterior Percutaneous Screw Fixation for Displaced Talar neck Fractures

전방 정복술 및 경피적 후방 압박나사 내고정술을 이용한 전위성 거골 경부 골절의 치료 결과

  • Park, Ji-Kang (Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University) ;
  • Kim, Yong-Min (Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University) ;
  • Choi, Eui-Sung (Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University) ;
  • Shon, Hyun-Chul (Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University) ;
  • Cho, Byung-Ki (Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University) ;
  • Cha, Jung-Kwan (Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University)
  • 박지강 (충북대학교 의과대학 정형외과학교실) ;
  • 김용민 (충북대학교 의과대학 정형외과학교실) ;
  • 최의성 (충북대학교 의과대학 정형외과학교실) ;
  • 손현철 (충북대학교 의과대학 정형외과학교실) ;
  • 조병기 (충북대학교 의과대학 정형외과학교실) ;
  • 차정권 (충북대학교 의과대학 정형외과학교실)
  • Received : 2013.04.12
  • Accepted : 2013.05.21
  • Published : 2013.06.15
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Abstract

Purpose: Posteroanterior screw fixation is biomechanically stronger than anteroposterior screw fixation. However, there are few literature about the correlation between clinical results and more strength by posteroanterior fixation. This study was performed to evaluate the clinical outcomes of the accelerated rehabilitation following anterior open reduction and posterior percutaneous screw fixation for displaced talar neck fractures. Materials and Methods: Eighteen cases were followed up for more than 1 year after posteroanterior fixation using headless compression screw for talar neck fractures. The clinical evaluation was performed according to American Orthopaedic Foot and Ankle Society (AOFAS) score and Hawkins criteria. As radiographic evaluation, the degree of fracture displacement, period to union, and occurrence rate of complications such as avascular necrosis through MRI were measured. Results: The AOFAS score was average 90.4 points at the last follow-up. There were 7 excellent, 9 good, and 2 fair results according to the Hawkins criteria. Therefore, 16 cases(88.8%) achieved satisfactory results. The degree of fracture displacement had improved significantly from preoperative average 5.6 mm to 1.2 mm immediate postoperatively, and maintained to 1.1mm at the last follow-up. All cases achieved bone union, and the period to union was average 12.4 weeks. There were 3 cases of avascular necrosis of talar body and 2 cases of post-traumatic arthritis. Conclusion: Anterior open reduction and posterior percutaneous headless screw fixation seems to be an effective surgical method for displaced talar neck fractures, because of the possibility of accurate restoration of articular surface, fixation strength enough to early rehabilitation, and needlessness of hardware removal.

Keywords

References

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