Talar neck fracture associated with talonavicular dislocation and fracture of posteromedial process of talus.

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Abstract

[Indexed for MEDLINE] 12. Ortop Traumatol Rehabil. 2018 Feb 27;20(1):31-42. doi: 10.5604/01.3001.0011.5842. Importance of Computed Tomography (CT) in Talar Neck Fractures. Case Studies. Stołtny T(1), Pasek J(2), Leksowska-Pawliczek M(3), Ostałowska A(4), Piechota M(1), Ochocki K(1), Wąsik J(1), Koczy-Baron A(1), Wawrzynek W(1), Kasperczyk S(4), Koczy B(1). Author information: (1)Samodzielny Publiczny Wojewódzki Szpital Chirurgii Urazowej im. Dra Janusza Daaba w Piekarach Śląskich / District Hospital of Orthopaedics and Trauma Surgery in PiekaryŚląskie, Piekary Śląskie, Poland. (2)Akademia im. Jana Długosza w Częstochowie Instytut Wychowania Fizycznego Turystyki i Fizjoterapii / Institute of Physical Education Tourism and Physiotherapy, Jan Długosz Academy in Częstochowa, Częstochowa, Poland. (3)Wielospecjalistyczny Szpital Powiatowy S.A. NZOZ Szpital im. dr B. Hagera w Tarnowskich Górach / Dr B. Hager Non-Public Multispeciality District Hospital in Tarnowskie Góry, Tarnowskie Góry, Poland. (4)Katedra i Zakład Biochemii Wydziału Lekarskiego z Oddziałem Dentystycznym w Zabrzu, ŚUM w Katowicach / Department of Biochemistry, Medical University of Silesia in Katowice, Zabrze, Poland. Computed tomography is a modern technique producing high quality image of scanned organs. It plays a significant role in diagnostic work-up on orthopedics wards. This paper presents an analysis of management of two cases of Hawkins type I talar neck fracture with ankle joint rotation. In both patients, the diagnosis was based on conventional radiographs of the ankle joint in two projections and was subsequently verified with CT scans. The findings of a CT scan of the talus had a significant impact on further treatment and physiotherapy. Non-surgical treatment consisting in immobilization with a short leg cast combined with medication and magnetic field therapy produced a positive therapeutic outcome. A follow-up CT scan of the talus revealed bone union with remodelling in both patients. The functional outcome according to the AOFAS scale should be regarded good. Computed tomography is the radiological modality for detecting talar neck fractures and determining the presence of displacement. Follow-up CT scans evaluate the natural process of bone healing, which is crucial for treatment decisions regarding weight-bearing status. A correct diagnosis based on CT helps to prevent the development of necrosis and posttraumatic (secondary) degenerative changes as well as advanced physical disability, especially among youn-ger patients, in whom the injury is most common, consequently helping to avoid a long and costly treatment. DOI: 10.5604/01.3001.0011.5842