|
Year |
2002 |
|---|---|
|
Question Number |
27. |
|
Category |
Foot and Ankle |
Question
In the surgical management of comminuted talar neck fractures, what is the most common position of malreduction?
1- Varus
2- Valgus
3- Flexion
4- Internal rotation
5- External rotation
Figures
Answer (click for answer)
Preferred Response: 1
Classification of Talar Neck Fractures
I Fracture of the Talar neck without displacement
II Characterized by displacement of the talar neck fracture and an associated subluxation of the subtalar joint
III Talar body is displaced from both the ankle and subtalar joints
IV Fracture of talar neck with subluxation/dislocation of the talar body and associated dislocation of the talar head.
Fractures and fracture dislocations of the talar neck account for 50% of all major injuries to the talus. Most talar neck fractures occur in young adults, with a 3:1 ration of men to women. Immediate reduction is the initial step in the management of these fractures. Fractures that are displaced require open reduction and internal fixation. Complications include skin necrosis, osteomyelitis, avascular necrosis, malunion, delayed union, nonunion and malunion. In a review of type II fractures, authors found that varus Malalignment was the most common. The incidence of malunion is 28%.
Reference: Beaty JH (ed): Orthopaedic Knowledge Update 6. Rosemont, IL, American Academy of Orthopaedic Surgeons, 1999, pp597-612.
Coughlin MJ, Mann RA (eds): Surgery of the Foot and Ankle 2 ed. St. Louis, MI, Mosby, 1999: 1465-1514.