Clinical outcomes after arthroscopically assisted talus fracture fixation
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ORIGINAL PAPER
Clinical outcomes after arthroscopically assisted talus fracture fixation Ciprian Alin Bardas 1 Thomas Bauer 3,4
&
Horea Rares Ciprian Benea 1 & Dragos Apostu 1 & Daniel Oltean-Dan 1 & Gheorghe Tomoaia 1,2 &
Received: 2 October 2020 / Accepted: 15 October 2020 # SICOT aisbl 2020
Abstract Purpose The purpose of this article is to describe the novel technique of arthroscopic-assisted reduction and internal fixation (ARIF) of talar neck fractures, presenting also the outcomes of this treatment method in a series of four patients. Methods Between 2011 and 2019, we have treated in our service a number of four patients with talar neck fractures, by the arthroscopic technique. The surgical intervention consists in arthroscopic exploration of tibiotalar and subtalar joints, arthroscopic lavage and debridement, reduction, and osteosynthesis with two cannulated screws under both arthroscopic and fluoroscopic control. Post-operative care consists in non-weightbearing immobilization for 6 weeks, followed by partial loading under the protection of a walking brace for the next six weeks and ROM exercises. The patients were followed up at three months, when a CT scan was performed, and at one year, when X-ray images showed the consolidation of fractures. Results Normal or slightly reduced ROM of the ankle and hindfoot was noted in three out of four patients, absence of any pain, or disability (3 patients). The AOFAS’ Ankle-Hindfoot scale showed good and excellent results; mean score was 92.75 points (86– 98p) at one year after the surgery. Conclusion Arthroscopic-assisted management of talar fractures offers the advantages of minimally invasive surgery combined with good visualization of the fracture, good control of anatomic reduction, and the possibility to treat associated lesions. Main disadvantages of the method are technical difficulties, requires a prolonged learning curve, and offers limited fixation alternatives. Keywords Talar neck fractures . Arthroscopy . Treatment . ARIF
Introduction Although talar fractures represent less than 1% of all fractures, they are severe injuries affecting the function of hindfoot and ankle joints. The treatment of talar fractures still represents a
difficult challenge even for experienced orthopaedic surgeons [1–4]. The outcome of these fractures correlates with the severity of the injury [1, 5, 6]. Clinical results of displaced fractures treatment are threatened by the risk of avascular osteonecrosis,
Level of evidence: Therapeutic study, cases report with no comparison group, Level IV * Horea Rares Ciprian Benea [email protected] Ciprian Alin Bardas [email protected]
Thomas Bauer [email protected] 1
“Iuliu Hatieganu” University of Medicine and Pharmacy, Orthopaedics and Traumatology Discipline, 47 Traian Mosoiu St., 400132 Cluj-Napoca, Romania
2
Daniel Oltean-Dan [email protected]
Academy of Romanian Scientists, 54 Splaiul Independentei St., Bucuresti, Romania
3
Gheorghe Tomoaia [email protected]
Hôpitaux Universitaires Paris Ile-de-
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