Clinical Application Of Cannulated Screw In Treatment Of Talus Frature

Objective Talus fracture is one of the rare fractures in the trauma orthopaedic, which has more serious complications and consequences. Once talus got hurt or treated improperly after injury, it may produce pain and affect the function of ankle joint, clinical treatment is more difficult. Therefore the clinical treatment of the talus fractures is very important in the fractures of whole body. And there are many controversies in the surgical timing, surgical approach and surgical methods of the talus fractures. This study is to evaluate the treatment effect of cannulated screw for talus fractures.Methods Twenty-four cases of talus fractures treated with cannulated screw from July2008to July2011were studied retrospectively, in which14males and10females with age of18～55years old (mean37.2years).The mechanism of injuries were a fall from the height in8patients, a traffic accident in12patients and other injury in4patients,6cases were open fractures,18cases were close fractures,5cases combined with fracture of tibia and fibula,3cases combined with fracture of calcaneus,2cases combined with fracture of metatarsals and5cases combined with multiple injuries or fractures. In18cases of Talar neck fractures, according to the Hawkins classification, there were3cases of typeⅠ,11cases of type Ⅱ,3cases of typeⅢ and1cases of typeⅣ. In6 cases of Talar body fractures, according to the Sneppen classification, there were4cases of type Ⅱ and2cases of typeV. By using anteromedial incision or interior and lateral incision approach, if necessary, extending the anteromedial incision to the back and combining with medial malleolus osteotomy to expose the fracture. Based on principle of early functional exercise and late weight-bearing, and post operation X-ray, to determine lower limb weight-bearing time.Results Twenty cases were followed up for10-20months, with an average of15.4months. According to AOFAS ankle-hindfoot scale score, the result showed excellent in9cases, good in7cases, fair in2cases and poor in2cases, good rate was80%.Conclusion According to talus fractures type and degree of soft tissue injury, to select appropriate surgical approaches and surgical timing. Application of cannulated screw may provide good fixed-effects, maintain an adequate and stable fracture reduction to initiate early range of motion and reduce hard-ware complications in treatment of talus fractures. Surgical procedure is simple. It is worthy of clinical application and further clinical study should be presented.