Clinical Evaluation of the Fracture of Talar Neck

거골 경부 골절에 대한 치료

The fracture and fracture-dislocation of the neck of the talus (Hawkins' type I-IV) are uncommon injuries and represent only 0.12 to 0.32% of all fracures. Authors clinically evaluated in 12 cases Whom treated fracures of the neck of the talus, at department of orthopaedic surgery, Sun General Hospital, from 1990 to 1996, and the following results are obtained. 1. Of 12 cases, there were 11 males and 1 female, average age was 30 years. 2. Causes of fracture was fall down injury in 7 cases(58%), traffic accident in 4 cases(33%), direct trauma in 1 case(8%). 3. According to the classification by Hawkins' type I in 2 cases(17%), type II in 7cases (58%), type III in 3cases(25%). 4. Associated injuries were calcaneal fracture in 3 cases, fracture-dislocation of talus in 3 cases, subtalar dislocation in 3 cases, medial malleolar fracture in 5 cases, soft tissue injury in 3 cases, femur and tibia fracture in 1 case, and lumbar Spine compression fracture in 1 case. 5. Average time to operation after injury was 2.5 days. 6. In 2 cases were treated conservatively and 10 cases were treated open reduction and internal fixation with screw or K-wire. 7. Complications were avascular necrosis in 4 cases, post traumatic arthritis in 2 cases, skin necrosis in 4 cases, and then ankle fusion was done in 2 cases. 8. High rate of complication was seen in the talar neck fracture associated with calcaneal fracture. In the analysis of above results, evaluated by Hawkins' scoring system were excellent to fair in 75%.