[Treatment of rare talus dislocation fractures. An analysis of 23 injuries].

METHODS

Between 1980 and 1996 we treated 23 patients for dislocated fractures of the talus. The injury was caused by a car accident in 61% and a high fall in 22%. Five patients had open wounds (22%), two developed compartment syndrome of the foot (9%) at an early stage, and 11 patients had multiple injuries. We used the classifications of Hawkins and Marti/Weber. All fractures were surgically treated by fixation with screw osteosynthesis, percutaneous wire transfixation, and/or external fixation. Fifteen patients with dislocated fractures of the talus underwent clinical and radiological follow-up examinations using the Kiel score.

RESULTS

Four patients had excellent and three good results. In five patients with moderate, two with adequate, and one with poor results, we found additional injuries to the ipsilateral foot or leg in 50%. Of those patients, 73% developed peritalar arthrosis and 39% talar necrosis. Due to bony defects, anatomical reconstruction was unsatisfactory in 48%.

CONCLUSIONS

Even immediate anatomical reduction and sufficient stabilization cannot always decrease the rate of talar necrosis and peritalar arthrosis.