VESELÝ, Radek, Martin KELBL, Juraj KACIÁN, Vladimír HULKA, Ján KOČIŠ and Radek KUNOVSKÝ. Zlomeniny krčku talu léčené perkutánně zavedenými šrouby (Talar Neck Fractures Treated Using Percutaneous Screw Fixation). Acta chirurgiae orthopaedicae et traumatologiae Čechoslovaca. Praha: Galén, 2017, vol. 84, No 2, p. 120-124. ISSN 0001-5415.
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Basic information
Original name Zlomeniny krčku talu léčené perkutánně zavedenými šrouby
Name in Czech Zlomeniny krčku talu léčené perkutánně zavedenými šrouby
Name (in English) Talar Neck Fractures Treated Using Percutaneous Screw Fixation
Authors VESELÝ, Radek (203 Czech Republic, guarantor, belonging to the institution), Martin KELBL (203 Czech Republic, belonging to the institution), Juraj KACIÁN (703 Slovakia), Vladimír HULKA (703 Slovakia, belonging to the institution), Ján KOČIŠ (703 Slovakia, belonging to the institution) and Radek KUNOVSKÝ (203 Czech Republic, belonging to the institution).
Edition Acta chirurgiae orthopaedicae et traumatologiae Čechoslovaca, Praha, Galén, 2017, 0001-5415.
Other information
Original language Czech
Type of outcome Article in a journal
Field of Study 30211 Orthopaedics
Country of publisher Czech Republic
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 0.645
RIV identification code RIV/00216224:14110/17:00098416
Organization unit Faculty of Medicine
UT WoS 000400881500007
Keywords in English talus;closed;reduction;percutaneous;fixation;screw
Tags EL OK
Tags International impact, Reviewed
Changed by Changed by: Soňa Böhmová, učo 232884. Changed: 20/3/2018 12:51.
Abstract
ABSTRACT PURPOSE OF THE STUDY Closed reduction and percutaneous fixation of nondisplacedtalar neck fractures have been applied by some authors. The aim of this paper is to assess the results and complications of this minimally invasive technique. MATERIAL AND METHODS In the period from 2009 to 2014, twenty-one patients with a talar neck fracture were observed after closed reduction and percutaneous screw fixation in the Traumatological Hospital in Brno. The mean age of the patients was 38 years (range 18-56 years). The mechanism of injury was a motor vehicle accident in 11 cases, a fall from height in six cases, a sports injury in 3 cases, and a fall from stairs in one case. Injuries were classified according to the Hawkins classification. Conventional preoperative 3-dimensional CT scans of the fractures were analysed. Under the guidance of C-arm fluoroscopy Kirscher wires were used for closed reduction and temporary percutaneous fixation. Subsequently, 3.5 and 4.5 mm diameter cannulated screws were inserted. The outcome was evaluated on the American Orthopaedic Foot and Ankle Society (AOFAS) scoring scale. RESULTS The average follow-up was 32 months (21-42 months). The average healing time was 15.5 weeks (13-19 weeks). The average AOFAS score was 82.3 points (69-96 points). 75% of patients with type I injury achieved excellent results and 72% of patients with type II injury achieved excellent or good results. None of the patients developed wound complications. Two patients developed partial avascular necrosis and three patients subtalar traumatic arthritis after surgery. DISCUSSION Talar neck fractures are relatively uncommon fractures. Most of the published studies are small. Tenuous blood supply and displaced talar neck fracture predispose to avascular necrosis of the talus. Closed reduction and percutaneous fixation can reduce the soft tissue damage and disturbance to the blood supply. CONCLUSIONS Preoperative 3D CT scans, early surgery, anatomic articular surface reduction and percutaneous screw fixation increase the fracture healing rate and reduce the incidence of talar avascular necrosis.
Abstract (in English)
ABSTRACT PURPOSE OF THE STUDY Closed reduction and percutaneous fixation of nondisplacedtalar neck fractures have been applied by some authors. The aim of this paper is to assess the results and complications of this minimally invasive technique. MATERIAL AND METHODS In the period from 2009 to 2014, twenty-one patients with a talar neck fracture were observed after closed reduction and percutaneous screw fixation in the Traumatological Hospital in Brno. The mean age of the patients was 38 years (range 18-56 years). The mechanism of injury was a motor vehicle accident in 11 cases, a fall from height in six cases, a sports injury in 3 cases, and a fall from stairs in one case. Injuries were classified according to the Hawkins classification. Conventional preoperative 3-dimensional CT scans of the fractures were analysed. Under the guidance of C-arm fluoroscopy Kirscher wires were used for closed reduction and temporary percutaneous fixation. Subsequently, 3.5 and 4.5 mm diameter cannulated screws were inserted. The outcome was evaluated on the American Orthopaedic Foot and Ankle Society (AOFAS) scoring scale. RESULTS The average follow-up was 32 months (21-42 months). The average healing time was 15.5 weeks (13-19 weeks). The average AOFAS score was 82.3 points (69-96 points). 75% of patients with type I injury achieved excellent results and 72% of patients with type II injury achieved excellent or good results. None of the patients developed wound complications. Two patients developed partial avascular necrosis and three patients subtalar traumatic arthritis after surgery. DISCUSSION Talar neck fractures are relatively uncommon fractures. Most of the published studies are small. Tenuous blood supply and displaced talar neck fracture predispose to avascular necrosis of the talus. Closed reduction and percutaneous fixation can reduce the soft tissue damage and disturbance to the blood supply. CONCLUSIONS Preoperative 3D CT scans, early surgery, anatomic articular surface reduction and percutaneous screw fixation increase the fracture healing rate and reduce the incidence of talar avascular necrosis.
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