[Arthroscopic-assisted closed reduction and internal fixation with absorbable screws for Hawkins type Ⅱ talar neck fractures].

OBJECTIVE

To explore the effectiveness of arthroscopic-assisted closed reduction and internal fixation with absorbable screws in the treatment of Hawkins type Ⅱ talar neck fractures.

METHODS

A retrospective analysis was conducted on the clinical data of 31 patients with closed Hawkins type Ⅱ talar neck fractures between October 2021 and July 2023, all of whom were treated with arthroscopic-assisted closed reduction and internal fixation with absorbable screws. There were 18 males and 13 females with an average age of 35.9 years (range, 17-61 years). Causes of injury included sports injuries in 26 cases and impact injuries in 5 cases. The time from fracture to operation was 3-5 days (mean, 3.7 days). During follow-up, ankle pain and function were assessed using the visual analogue scale (VAS) score and the American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Score (AOFAS-AHS), while radiological examinations were used to evaluate the quality of fracture reduction and healing.

RESULTS

All operations were successfully completed, and all incisions healed by first intention. All patients were followed up 12-16 months (mean, 13.0 months). One patient experienced persistent pain, limping, and joint dysfunction postoperatively, which returned to normal after symptomatic treatment. At 3 months after operation and last follow-up, the VAS scores were 2.7±0.9 and 1.3±0.8, respectively; the AOFAS-AHS were 74.5±4.7 and 90.9±3.6, respectively. There were significant differences in VAS score and AOFAS-AHS between different time points ( P<0.05). At last follow-up, all fractures healed, and the internal fixation was secure. No complication such as talar necrosis, subtalar joint stiffness, wound infection, or screw irritation occurred during follow-up.

CONCLUSION

Arthroscopic-assisted closed reduction and internal fixation with absorbable screws for Hawkins type Ⅱ talar neck fractures has the advantages of minimal trauma, precise screw placement, few complications, and avoiding secondary screw removal, with satisfactory effectiveness.