Union Rates of Talar Neck Fractures With Substantial Bone Defects Treated With Autograft.

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Abstract

[Indexed for MEDLINE] 6. Foot Ankle Int. 2023 May;44(5):392-400. doi: 10.1177/10711007231160751. Epub 2023 Mar 30. Association of Talar Neck Fractures With Body Extension and Risk of Avascular Necrosis. Mechas CA(1), Aneja A(1), Nazal MR(1), Pectol RW(1), Sneed CR(1), Foster JA(1), Kinchelow DL(1), Kavolus MW(1), Landy DC(1), Srinath A(1), Moghadamian ES(1). Author information: (1)Department of Orthopaedic Surgery & Sports Medicine, University of Kentucky, Lexington, KY, USA. Comment in Foot Ankle Int. 2023 May;44(5):401-402. doi: 10.1177/10711007231167350. Comment on J Bone Joint Surg Am. 2014 Feb 5;96(3):192-7. doi: 10.2106/JBJS.L.01680. BACKGROUND: The objective of this study was to determine whether talar neck fractures with proximal extension (TNPE) into the talar body are associated with higher rates of avascular necrosis (AVN) compared to isolated talar neck (TN) fractures. METHODS: A retrospective review of patients sustaining talar neck fractures at a level I trauma center from 2008 to 2016 was performed. Demographic and clinical data were collected from the electronic medical record. Fractures were characterized as TN or TNPE based on initial radiographs. TNPE was defined as a fracture that originates on the talar neck and extends proximal to a line subtended from the junction of the neck and the articular cartilage dorsal to the anterior portion of the lateral process of the talus. Fractures were classified according to the modified Hawkins classification for analysis. The primary outcome was the development of AVN. Secondary outcomes included nonunion and collapse. These were measured on postoperative radiographs. RESULTS: There were 137 fractures in 130 patients, with 80 (58%) fractures in the TN group and 57 (42%) in the TNPE group. Median follow-up was 10 months (interquartile range, 6-18 months). The TNPE group was more likely to develop AVN as compared to the TN group (49% vs 19%, P