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Closed reduction and posterior percutaneous internal fixation for simple displaced talar neck fracture: a retrospective comparative study

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Abstract

Purpose

Open reduction and internal fixation (ORIF) is the most commonly used surgical technique for talar neck fracture, but there are high risks for complications and poor functional outcomes. In this study, we reported the closed reduction and percutaneous internal fixation (CRPIF) technique of the bilateral approach of the Achilles tendon for simple displaced talar neck fracture, in comparison with ORIF.

Methods

Data of 15 patients in the CRPIF group and 22 in the ORIF group were included. The American Orthopaedic Foot and Ankle Society (AOFAS) score, Visual Analog Scale (VAS) score, 12-item Short-Form Survey (SF-12) score, range of motion (ROM), complications, and radiographic results were recorded and compared.

Results

The mean follow-up in the CRPIF group was 33.9 months. Complications included two cases of avascular necrosis (AVN) and two cases of osteoarthritis. All patients achieved bony union and recovered their pre-operative mobility. The mean follow-up in the ORIF group was 39 months. Complications included two cases of bony nonunion, nine AVN, and seven cases of osteoarthritis. Moreover, the mobility of the ORIF group was significantly lower than the CRPIF group post-operatively. The AOFAS score, VAS score, and SF-12 physical component score (PCS) for the CRPIF group were better improved than those for the ORIF group (ALL, P < 0.05).

Conclusions

The CRPIF technique of the bilateral approach of the Achilles tendon was an effective method for the treatment of simple displaced talar neck fractures. Compared with the ORIF, the limited blood supply of the talus was protected, provide better functional outcomes and biomechanical fixation, and lower incidence of resurgery and complication in the CRPIF.

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Data availability

The data of this study were real. The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to acknowledge the significant contribution of the patients, families, researchers, and clinical staff included in this study.

Funding

This work was supported by the Key R & D plan of Shaanxi Province (No. 2021SF-025), Scientific research projects of Xi’an Health Commission (No. 2021ms07).

Author information

Authors and Affiliations

  1. Foot and Ankle Surgery Department, Honghui Hospital of Xi’an Jiaotong University, Xi’an, Shanxi, 710054, China

    Xin-Quan Yang, Yan Zhang, Qiong Wang, Jing-Qi Liang, Yi-Ding Tang, Xiao-Jun Liang & Hong-Mou Zhao

  2. Xi’an Medical University, Xi’an, Shanxi, 710068, China

    Xin-Quan Yang & Yi-Ding Tang

  3. Youjiang Medical University for Nationalities, Baise, Guangxi, 533000, China

    Ji-Hong Jia

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  1. Xin-Quan Yang
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Contributions

HMZ contributed to the study design, operation, and is the corresponding author. XQY and YZ participated in designing the research, collecting the data and manuscript draft. QW, YDT, and JQL participated in the statistical analysis and the literature search. JHJ prepared the figures and tables. ZHM and LXJ critically revised the manuscript for important intellectual content and gave the final approval of the version to be published. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hong-Mou Zhao.

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This study has been approved by the ethical committee of Honghui Hospital.

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We have obtained the consent to participate from the participants.

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The authors declare no competing interests.

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Yang, XQ., Zhang, Y., Jia, JH. et al. Closed reduction and posterior percutaneous internal fixation for simple displaced talar neck fracture: a retrospective comparative study. International Orthopaedics (SICOT) 46, 2135–2143 (2022). https://doi.org/10.1007/s00264-022-05432-y

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