The Comparison Study Between Headless Compression Screw And Hollow Cannulated Compression Screw Using For Talus Neck Fracture(Hawkins Type Ⅲ And Ⅳ ) Through Malleolus Osteotomy Approach

Objective:To compare the surgical treatment of talus neck fractures(Hawkins type III and IV)treated with headless compression screw and hollow cannulated compression screw through malleolus osteotomy approach MethodFrom March 2013 to March 2015, in the experimental group 20 cases of talus neck fractures accepted surgical treatment in our hospital. They were treated with headless compression screw through malleolus osteotomy approach. In the control group 21 cases of talus neck fractures were treated with hollow cannulated compression screw through malleolus osteotomy approach. The patient’s operation time, blood loss, hospital stay, wound healing, fracture healing as well as the incidence of necrosis of the talus were recorded to compare the effectiveness of this treatment between the two groups. ResultAll patients were followed up for 1-2 years, with an average interval time of 1.8 years.In the experimental group, the average age of the patients was 33.25±8.28 years(20-45 years old). Of these 20 cases of talar neck fractures, there were 13 cases belonged to Hawkins type III, and 7 cases Hawkins IV. The average surgery time was 61.55±10.64 minutes(45-87 minutes), the mean blood loss was 114.55±38.13 ml(45-200ml), the average number of days of hospitalization was 10.60±2.30 days(7-15 days). There was no wound infection in all the 20 patients, and all the fractures healed in one stage.But after 2 cases occured avascular necrosis of the talus. According to American Orthopaedic Foot and Ankle Society Scoring System(AOFAS), there were 10 excellent cases, 8 good cases, 2 fair cases and no poor cases. The overall excellent rate was 90%. In the control group, the average age of the patients was 31.95±7.78 years(21-47 years old). Of these 21 cases of talar neck fractures, there were 12 cases belonged to Hawkins type III, and 9 cases Hawkins IV. The average surgery time was 61.90±6.02 minutes(44-80 minutes), the mean blood loss was 112.19±20.74 ml(50-180ml), the average number of days of hospitalization was 11.57±1.72 days(8-16 days). There was no wound infection in all the 21 patients, and all the fractures healed in one stage. But 8 cases occured avascular necrosis of the talus. According to American Orthopaedic Foot and Ankle Society Scoring System(AOFAS), there were 7 excellent cases, 1 good cases, 8 fair cases and no poor cases. The overall excellent rate was 90%. There was no statistically significant difference in age, gender, fracture type, operation time, blood loss, hospital stay(p value>0.05), there was statistically significant difference in incidence of necrosis of the talus and excellent rate between experimental group and control groupall( p value<0.05). Conclusion:The clinical results of talus neck fractures treated with headless compression screw was better than hollow cannulated compression screw through malleolus osteotomy approach, with lower incision complications and higher union rate of fracture.