Talus Injuries And Necrosis And Its Treatment

With the development of the modern communicant and the architecture industry, the rate of the talus injuries is also stepping up. Because of the blood supply of talus injuries is specially, and the necrosis of the talus is happening easily. It is difficult to cure the talus injuries that the rate of traumatic arthritis is large because of the talus injuries is intraarticular fracture.Objective To retrospectively evaluate results of surgical treatment of talus injuries and necrosis , in order to find the best way of surgical treatment to decrease the complications of talus injuries.Methods Twenty-five cases of talus injuries and thirteen cases of necrosis are treated in our department from January 1998 to October 2006 who have been followed up are retrospective reviewed. There is one case of the simple dislocation. Based on the Hawkins classification, there are nineteen cases of talus neck fractures includes 5 cases of typeâ… ,8 cases of typeâ…¡,4 cases of typeâ…¢and 2 cases of typeâ…£. There are 3 cases of talus body fractures and 2 cases of talus head fractures. The six patients are treated non-operatively and immobilized with plaster splint. All the other patients are treated with open reduction internal fixation. In the group of necrosis there are nineteen cases ,and seven patients are treated with non-operation and six patients are treated with operation.Results The follow-ups is respectively averaging five and four point five years According to Hawkins evaluation system ,In the group of talus injures fifteen cases are assessed as excellent and good ,eight as pair, two as poor, the good to excellent rate is 60â„…. In the group of the necrosis six cases are assessed as excellent and good, six as pair, one as poor, the good to excellent rare is 46.2â„….Conclusion 1.The treatment of talus injure:â‘ The simple dislocation of talus to accompany seriously damaging of the blood supply of talus must early adopt closed replacement, in order to reduce the happening of talus necrosis .â‘¡Expectant treatment of the occlusion replacement is the fist selection for the simple fracture or easy replacement of the caput tali fracture. The unsatisfactory replacement of the fracture is treated with open reduction internal fixation, and need not arthrodesis.â‘¢The typeâ… andâ…¡fractures of collum tali fractures generally adopt non-operatively and immobilized with plaster splint. However the obsolete and failure replacement typeâ…¡and typeâ…¢-â…£fracture are treated with open-reduction internal fixation and arthrodesis of the joint between talus and calcaneus.â‘£The corpus tali fractures of the non-shifting and light aversion adopt non-operatively and immobilized with plaster splint. To the comminuted fractures of the body of talus are treated with open-reduction internal fixation and arthrodesis of the joint between talus and calcaneus that can improve curative effect. 2.The treatment of the talus necrosis:â‘ The talus necrosis of the light degree and torpidity progression can adopt expectant treatment.â‘¡To the talus necrosis of the light deform and rapid progress adopt arthrodesis of the subtalar joint ,in order to improve the blood supply of talus, and prevent the aggravation of necrosis to hamper the deform and collapse of talus.â‘¢To the talus necrosis of the severe deform and collapse also can adopt to cut talus. With the development of the artificial joint prosthetic replacement of the ankle joint will be the best selection.