Analysis The Treatment Efficacy Of Talus Fractures In Pediatric:A Retrospective Study Of 25 Cases

Objective: To provide references and bases for further improve the treatment of talus fractures in pediatric.Methods: Retrospective analysis 25 cases of pediatric talus fractures in our hospital from November 2010 to November 2016,including the fractures of talar head(n=1),neck(n=12),body(n=6),and the combined talar fractures(n=6).According to the different types of talus fracture,different treatment were taken,including conservative treatment in 6 cases,and operative treatment in 19 cases with Kirschner wire,cartilage nail,cannulated screw,bioabsorbable screw or straddle nail for internal fixation in fractures.Results: According to AOFAS evaluation for the functions of ankle and foot,13 cases were excellent,7 cases were good and 5 cases were fair after 21.6 months follow-up in average.There were 2 cases with infection and necrosis of epidermis before surgery.During follow-ups,avascular necrosis of the talus body(n=10),osteoarthritis(n=4),malunion(n=3)were observed.We found that the patients younger than 10 years or operationwithin 7 days after the trauma had the better prognosis(P<0.05),and the patients with serious displacement had more opportunity to get avascular necrosis of the talus(P<0.05).Conclusions: The patient with no or little displacement can be managed conservatively,and those with obvious displacement should be treated operatively by anteromedial approach within 7 days,the internal fixation can be cannulated screw,bioabsorbable screw,Kirschner wire or cartilage nail.In operation the blood supply of talus shoud be protected and the anatomic reduction should be achieved as much as possible.Early exercise and late weight-bearing principle can significantly improve the result in the talus fracture patients.