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Clinical and radiological outcomes of ankle joint preserving surgical reconstruction for talar neck non-unions-A series of 8 cases.
- Source :
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Injury [Injury] 2024 Jun; Vol. 55 Suppl 2, pp. 111409. Date of Electronic Publication: 2024 Aug 02. - Publication Year :
- 2024
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Abstract
- Background: Talar neck non-unions result in significant hindfoot deformity and morbidity and are infrequently reported in the literature. The optimal surgical management for this condition is evolving, with various authors reporting the results of open reduction and internal fixation (ORIF) with bone grafting (BG), ankle fusion and modified Blair fusion. We performed this study to report the clinical and radiological outcomes of a cohort of talar neck non-unions managed by ankle joint preserving reconstruction.<br />Methods: This was an ambispective study which included 8 patients (7 male and 1 female) with talar neck non-unions. All patients underwent ORIF+BG through dual approaches. Additional medial malleolar osteotomy was done in 2 cases, and calcaneofibular split approach to the subtalar joint in 3. Adjunct subtalar fusion was done in 5 cases. Clinical and radiological evaluation was performed pre- and post-operatively. Functional outcomes were assessed by the Manchester Oxford Foot Questionnaire (MOxFQ).<br />Results: The mean age of patients 32.3 ± 13.1 years. The mean surgical delay was 4.1 ± 1.7 months. As per Zwipp and Rammelt classification of post-traumatic talar deformities, 5 cases were classified as Type 3, 2 were Type 4, and 1 was Type 1. Union was achieved in 7 cases at a mean of 3.4 ± 1.3 months. One case had progressive collapse, which was managed by pantalar arthrodesis. All 3 cases where subtalar fusion was not performed primarily demonstrated subtalar arthrosis, but none required a secondary subtalar fusion. The MOxFQ score from 61.1 ± 10.1 to 41 ± 14.1 postoperatively (P = 0.005). The mean follow-up was 14.6 ± 6.8 months.<br />Conclusion: ORIF+BG of the talar neck, with or without subtalar fusion has the potential to achieve solid union, correct the hindfoot deformity and improve functional outcomes. However, larger studies with longer follow-up are needed to evaluate the long-term efficacy of this procedure.<br />Competing Interests: Declaration of competing interest The authors have no declarations and no conflicts of interest.<br /> (Copyright © 2024 Elsevier Ltd. All rights reserved.)
- Subjects :
- Humans
Male
Female
Adult
Treatment Outcome
Arthrodesis methods
Osteotomy methods
Middle Aged
Young Adult
Fracture Healing physiology
Plastic Surgery Procedures methods
Retrospective Studies
Range of Motion, Articular
Ankle Fractures surgery
Ankle Fractures diagnostic imaging
Fracture Fixation, Internal methods
Ankle Joint surgery
Ankle Joint diagnostic imaging
Ankle Joint physiopathology
Fractures, Ununited surgery
Fractures, Ununited diagnostic imaging
Talus surgery
Talus diagnostic imaging
Radiography
Bone Transplantation methods
Subjects
Details
- Language :
- English
- ISSN :
- 1879-0267
- Volume :
- 55 Suppl 2
- Database :
- MEDLINE
- Journal :
- Injury
- Publication Type :
- Academic Journal
- Accession number :
- 39098787
- Full Text :
- https://doi.org/10.1016/j.injury.2024.111409