European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026
Impact of fixation method on avascular necrosis in talar neck fractures: a retrospective analysis.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Page Brendan E, Rechter Griffin R, Nasir Bader A, Yawman Jonathan P, Jacobs Elizabeth D, Langford Joshua R, Haidukewych George J, Shaath M Kareem
Аннотация
PURPOSE: To compare clinical outcomes and complication rates between plate with independent screw fixation versus screw fixation alone in the management of talar neck fractures (AO/OTA 81.2), with a primary focus on avascular necrosis (AVN).
METHODS: A retrospective review was performed of adult patients who underwent operative fixation of talar neck fractures at a single Level I trauma center between 2017 and 2022, with a minimum follow-up of 3 months. Patients were divided into screw fixation alone (S) and plate with independent screw fixation (PS) groups. The primary outcome was avascular necrosis (AVN). Secondary outcomes included fracture union, post-traumatic arthrosis (PTA), infection, and unplanned reoperation. Multivariable logistic regression was performed to identify factors associated with AVN.
RESULTS: Seventy patients were included (33 S, 37 PS) with no differences in baseline demographics, comorbidities, or injury characteristics (p > 0.05). Union rates were similar between groups (p = 0.23). The incidence of AVN was significantly higher in the S group compared to the PS group (52% vs 22%, p = 0.01). There were no differences in rates of PTA, infection, or reoperation (p > 0.05). On multivariable analysis, plate fixation was associated with a significantly lower likelihood of AVN (OR 0.16, 95% CI 0.03-0.70; p < 0.01).
CONCLUSION: In this retrospective cohort, plate with independent screw fixation was associated with a significantly lower risk of avascular necrosis compared to screw fixation alone in talar neck fractures, while maintaining similar union and complication rates.
METHODS: A retrospective review was performed of adult patients who underwent operative fixation of talar neck fractures at a single Level I trauma center between 2017 and 2022, with a minimum follow-up of 3 months. Patients were divided into screw fixation alone (S) and plate with independent screw fixation (PS) groups. The primary outcome was avascular necrosis (AVN). Secondary outcomes included fracture union, post-traumatic arthrosis (PTA), infection, and unplanned reoperation. Multivariable logistic regression was performed to identify factors associated with AVN.
RESULTS: Seventy patients were included (33 S, 37 PS) with no differences in baseline demographics, comorbidities, or injury characteristics (p > 0.05). Union rates were similar between groups (p = 0.23). The incidence of AVN was significantly higher in the S group compared to the PS group (52% vs 22%, p = 0.01). There were no differences in rates of PTA, infection, or reoperation (p > 0.05). On multivariable analysis, plate fixation was associated with a significantly lower likelihood of AVN (OR 0.16, 95% CI 0.03-0.70; p < 0.01).
CONCLUSION: In this retrospective cohort, plate with independent screw fixation was associated with a significantly lower risk of avascular necrosis compared to screw fixation alone in talar neck fractures, while maintaining similar union and complication rates.