Skip to main content Skip to main navigation menu Skip to site footer

Current concept management of talus fracture: a literature review

  • Bintang Soetjahjo ,
  • Zarkasyi Arimuqti ,

Abstract

Fractures of the talus are uncommon. The relative infrequency of these injuries relates to limited guidelines to treat talus fracture. Talus fracture is always associated with high energy injury critical to the normal function of the ankle, subtalar, and transverse tarsal joints.  Outcomes vary widely and are related to the degree of initial fracture displacement. Nondisplaced fractures have a favorable outcome in most cases. Failure to recognize fracture displacement (even when minimal) can lead to undertreatment and poor outcomes. Current detailed diagnoses through Multidetector CT (MDCT) are preferred to avoid miss diagnosed in talar fracture. Although early treatment and delayed treatment did not significantly differ, multiple-choice to treat talus fracture should be known. Conservative and operative treatment can be done in accordance with clinical findings and fracture patterns. With a high risk of complication, appropriate therapy should be done. Many research and articles have been done to develop the treatment and reduce complications over talar fracture from an invasive procedure to a non-invasive procedure like arthroscopy. Therefore, we compile current treatment to give another perspective for surgeons to treat talar fracture patients

References

  1. Summers JN, Murdoch MM. Fractures of the Talus: A Comprehensive Review. Clin Podiatr Med Surg. 2012;29(2):188-203.
  2. Sakaki MH, Saito GH, de Oliveira RG, Ortiz RT, Silva Jdos S, Fernandes TD, et al. Epidemiological study on talus fractures. Rev Bras Ortop. 2014;49(4):334-9.
  3. Elgafy H, Ebraheim NA, Tile M, Stephen D, Kase J. Fractures of the talus: experience of two level 1 trauma centers. Foot Ankle Int. 2000;21(12):1023-1029.
  4. Liu X, Zhang H, Liu L, Fang Y, Huang F. Open Talus Fractures: Early Infection and Its Epidemiological Characteristics. J Foot Ankle Surg. 2019;58(1):103-108.
  5. Prasarn ML, Miller AN, Dyke JP, Helfet DL, Lorich DG. Arterial anatomy of the talus: a cadaver and gadolinium-enhanced MRI study. Foot Ankle Int. 2010;31(11):987-993.
  6. Mulfinger GL, Trueta J. The blood supply of the talus. J Bone Joint Surg Br. 1970;52(1):160-167.
  7. Meinberg EG, Agel J, Roberts CS, Karam MD, Kellam JF. Fracture and Dislocation Classification Compendium-2018. J Orthop Trauma. 2018;32 Suppl 1:S1-S170.
  8. Early JS. Talus fracture management. Foot Ankle Clin. 2008;13(4):635-657.
  9. Vallier HA. Fractures of the Talus: State of the Art. J Orthop Trauma. 2015;29(9):385-392.
  10. Hawkins LG. Fractures of the neck of the talus. J Bone Joint Surg Am. 1970;52(5):991-1002.
  11. Canale ST, Kelly FB Jr. Fractures of the neck of the talus. Long-term evaluation of seventy-one cases. J Bone Joint Surg Am. 1978;60(2):143-156.
  12. Sneppen O, Christensen SB, Krogsoe O, Lorentzen J. Fracture of the body of the talus. Acta Orthop Scand. 1977;48(3):317-324.
  13. Fortin PT, Balazsy JE. Talus fractures: evaluation and treatment. J Am Acad Orthop Surg. 2001;9(2):114-127.
  14. Watanabe H, Majima T, Takahashi K, Kawaji H, Takai S. Split Fracture of the Posteromedial Tubercle of the Talus: Case Report and Proposed Classification System. J Foot Ankle Surg. 2017;56(1):187-190.
  15. Inokuchi S, Ogawa K, Usami N. Classification of fractures of the talus: clear differentiation between neck and body fractures. Foot Ankle Int. 1996;17(12):748-750.
  16. Azeez A, Srinivasan N, Reddy VN. Management of Fracture Neck of Talus and Clinical Evaluation. 2018;4(3):16-21.
  17. Abdelgaid SM, Ezzat FF. Percutaneous reduction and screw fixation of fracture neck talus. Foot Ankle Surg. 2012;18(4):219-228.
  18. Caracchini G, Pietragalla M, De Renzis A, Galluzzo M, Carbone M, Zappia M, et al. Talar fractures: radiological and CT evaluation and classification systems. Acta Biomed. 2018;89(1-S):151-165.
  19. Haapamaki VV, Kiuru MJ, Koskinen SK. Ankle and foot injuries: analysis of MDCT findings. AJR Am J Roentgenol. 2004;183(3):615-622.
  20. Bykov Y. Fractures of the talus. Clin Podiatr Med Surg. 2014;31(4):509-521.
  21. Hagino T, Ochiai S, Watanabe Y, Senga S, Wako M, Ando T, Sato E, Haro H. Complications after arthroscopic knee surgery. Arch Orthop Trauma Surg. 2014;134(11):1561-1564.
  22. Vallier HA, Nork SE, Barei DP, Benirschke SK, Sangeorzan BJ. Talar neck fractures: results and outcomes. J Bone Joint Surg Am. 2004;86(8):1616-1624.
  23. Gonzalez A, Stern R, Assal M. Reduction of irreducible Hawkins III talar neck fracture by means of a medial malleolar osteotomy: a report of three cases with a 4-year mean follow-up. J Orthop Trauma. 2011;25(5):e47-e50.
  24. Cartwright-Terry M, Pullen H. Non-operative management of a talar body fracture in a skeletally immature patient. Acta Orthop Belg. 2008;74(1):137-140.
  25. Rammelt S, Zwipp H. Talar neck and body fractures. Injury. 2009;40(2):120-135.
  26. Fournier A, Barba N, Steiger V, Lourdais A, Frin JM, Williams T, et al. Total talar fracture - long-term results of internal fixation of talar fractures. A multicentric study of 114 cases. Orthop Traumatol Surg Res. 2012;98(4 Suppl):S48-55.
  27. Vallier HA, Nork SE, Benirschke SK, Sangeorzan BJ. Surgical treatment of talar body fractures. J Bone Joint Surg Am. 2004 Sep;86-A Suppl 1(Pt 2):180-192.
  28. Rush SM, Jennings M, Hamilton GA. Talus fractures: surgical principles. Clin Podiatr Med Surg. 2009;26(1):91-103.
  29. Xue Y, Zhang H, Pei F, Tu C, Song Y, Fang Y, et al. Treatment of displaced talar neck fractures using delayed procedures of plate fixation through dual approaches. Int Orthop. 2014;38(1):149-54.
  30. Abdelkafy A, Imam MA, Sokkar S, Hirschmann M. Antegrade-retrograde opposing lag screws for internal fixation of simple displaced talar neck fractures. J Foot Ankle Surg. 2015;54(1):23-28.
  31. Melenevsky Y, Mackey RA, Abrahams RB, Thomson NB 3rd. Talar Fractures and Dislocations: A Radiologist’s Guide to Timely Diagnosis and Classification. Radiographics. 2015;35(3):765-779.
  32. Maceroli MA, Wong C, Sanders RW, Ketz JP. Treatment of Comminuted Talar Neck Fractures With Use of Minifragment Plating. J Orthop Trauma. 2016;30(10):572-578.
  33. Wu JQ, Ma SH, Liu S, Qin CH, Jin D, Yu B. Safe Zone of Posterior Screw Insertion for Talar Neck Fractures on 3-Dimensional Reconstruction Model. Orthop Surg. 2017;9(1):28-33.
  34. Baoqing Y. Surgical Approaches for Talar Body Fracture. Foot Ankle Stud. 2017;1(1):1005.
  35. Buza JA 3rd, Leucht P. Fractures of the talus: Current concepts and new developments. Foot Ankle Surg. 2018;24(4):282-290.
  36. Daghino W, Di Gregorio G, Cerlon R. Surgical reconstruction of a crush injury of the talar body: a case report. J Bone Joint Surg Am. 2011;93(14):e80.
  37. Perera A, Baker JF, Lui DF, Stephens MM. The management and outcome of lateral process fracture of the talus. Foot Ankle Surg. 2010;16(1):15-20.
  38. von Winning D, Lippisch R, Pliske G, Adolf D, Walcher F, Piatek S. Surgical treatment of lateral and posterior process fractures of the talus: Mid-term results of 15 cases after 7 years. Foot Ankle Surg. 2020;26(1):71-77.
  39. Young KW, Park YU, Kim JS, Cho HK, Choo HS, Park JH. Misdiagnosis of Talar Body or Neck Fractures as Ankle Sprains in Low Energy Traumas. Clin Orthop Surg. 2016;8(3):303-309. d
  40. Miller S. Fracture of The Lateral Process of The Talus: Snowboarder’ s Fracture. Podiatryinstitute. 2008;(23):119-123.
  41. Ebraheim NA, Karkare N, Gehling DJ, Liu J, Ervin D, Werner CM. Use of a 30-degree external rotation view for posteromedial tubercle fractures of the talus. J Orthop Trauma. 2007;21(8):579-582.
  42. Mehrpour SR, Aghamirsalim MR, Sheshvan MK, Sorbi R. Entire Posterior Process Talus Fracture: A Report of Two Cases. J Foot Ankle Surg. 2012;51(3):326-329.
  43. Romeo NM, Hirschfeld AG, Githens M, Benirschke SK, Firoozabadi R. Significance of Lateral Process Fractures Associated With Talar Neck and Body Fractures. J Orthop Trauma. 2018;32(12):601-606.
  44. Bonasia DE, Rossi R, Saltzman CL, Amendola A. The role of arthroscopy in the management of fractures about the ankle. J Am Acad Orthop Surg. 2011;19(4):226-235.
  45. Kadakia R, Konopka J, Rodik T, Ahmed S, Labib SA. Arthroscopic Reduction and Internal Fixation (ARIF) of a Comminuted Posterior Talar Body Fracture: Surgical Technique and Case Report. Foot Ankle Spec. 2017;10(5):465-469.
  46. Hoogeslag RAG, Brouwer RW, Van Raay JJAM. The value of tourniquet use for visibility during arthroscopy of the knee: A double-blind, randomized controlled trial. Arthrosc - J Arthrosc Relat Surg. 2010;26(9 Suppl):S67-S72.
  47. Zaidi R, Hasan K, Sharma A, Cullen N, Singh D, Goldberg A. Ankle arthroscopy: A study of tourniquet versus no tourniquet. Foot Ankle Int. 2014;35(5):478-482.
  48. Vega J, Dalmau-Pastor M, Malagelada F, Fargues-Polo B, Peña F. Ankle Arthroscopy: An Update. J Bone Joint Surg Am. 2017;99(16):1395-1407.
  49. Zengerink M, Struijs PAA, Tol JL, van Dijk CN. Treatment of osteochondral lesions of the talus: A systematic review. Knee Surgery, Sport Traumatol Arthrosc. 2010;18(2):238-246.
  50. Choi SW, Lee GW, Lee KB. Arthroscopic Microfracture for Osteochondral Lesions of the Talus: Functional Outcomes at a Mean of 6.7 Years in 165 Consecutive Ankles. Am J Sports Med. 2020;48(1):153-158.
  51. Yang HY, Lee KB. Arthroscopic Microfracture for Osteochondral Lesions of the Talus: Second-Look Arthroscopic and Magnetic Resonance Analysis of Cartilage Repair Tissue Outcomes. J Bone Joint Surg Am. 2020;102(1):10-20.
  52. Frank RM, Hsu AR, Gross CE, Walton DM, Lee S. Open and arthroscopic surgical anatomy of the ankle. Anat Res Int. 2013;2013:182650.
  53. Funasaki H, Hayashi H, Sugiyama H, Marumo K. Arthroscopic reduction and internal fixation for fracture of the lateral process of the talus. Arthrosc Tech. 2015;4(1):e81-e86.
  54. Cole G, Beale B. Minimally Invasive Osteosynthesis Techniques for Articular Fractures. Vet Clin North Am Small Anim Pract. 2020;50(1):213-230.
  55. Lee C, Brodke D, Perdue PW Jr, Patel T. Talus Fractures: Evaluation and Treatment. J Am Acad Orthop Surg. 2020;28(20):e878-e887.
  56. Sitte W, Lampert C, Baumann P. Osteosynthesis of Talar Body Shear Fractures Assisted by Hindfoot and Subtalar Arthroscopy: Technique Tip. Foot Ankle Int. 2012;33(1):2012-2013.
  57. Hamed HL, Yehya MA, El-behairy HF, Ayman K Saleh, Abdelaziz A. Comparative study between usage of Herbert screw versus Kirschner wires in the management of nonunited fracture scaphoid. Sci J Al-Azhar Med Fac. 2019.;3(1):195-204
  58. Leie M, Heath E, Shumborski S, Salmon L, Roe J, Pinczewski L. Midterm Outcomes of Arthroscopic Reduction and Internal Fixation of Anterior Cruciate Ligament Tibial Eminence Avulsion Fractures With K-Wire Fixation. Arthrosc J Arthrosc Relat Surg. 2019;35(5):1533-1544.
  59. Gitajin IL, Abousayed M, Toussaint RJ, Ting B, Jin J, Kwon JY. Anatomic alignment and integrity of the sustentaculum tali in intra-articular calcaneal fractures: Is the sustentaculum tali truly constant?. J Bone Jt Surg Am Vol. 2014;96(12):1000-1005.
  60. Ohl X, Harisboure A, Hemery X, Dehoux E. Long-term follow-up after surgical treatment of talar fractures: Twenty cases with an average follow-up of 7.5 years. Int Orthop. 2011;35(1):93-99.
  61. Shank JR, Benirschke SK, Swords MP. Treatment of Peripheral Talus Fractures. Foot Ankle Clin. 2017;22(1):181-192.
  62. Petersen EJ, Rivera KP, Painter EE, Deyle GD, Croy T, Allen C. Manual Physical Therapy Following Immobilization for Stable Ankle Fracture: A Case Series. J Orthop Sport Phys Ther. 2015;45(9):665-674.
  63. Albin SR, Koppenhaver SL, Van Boerum DH, McPoil TG, Morgan J, Fritz JM. Timing of initiating manual therapy and therapeutic exercises in the management of patients after hindfoot fractures: a randomized controlled trial. J Man Manip Ther. 2018;26(3):147-156.
  64. Kalmet PHS, Sanduleanu S, Horn YY V, Poeze M, Brink PRG. Is early Weight Bearing Allowed in Surgically Treated Talar Neck Fractures? J Orthop Case Reports. 2016;6(3):73-74.
  65. Wagener J, Hintermann B. Percutaneous Fixation of Talus Fracture. In: Operative Techniques: Foot and Ankle Surgery. 2nd Edition: Elsevier Inc. 2017, p. 337-344.
  66. Ahn JH, Park D, Park YT, Park J, Kim YC. What should we be careful of ankle arthroscopy? J Orthop Surg. 2019;27(3):1-9.
  67. Smith JW, Daniels TR. Foot Fellow’ s Review. Foot Ankle Int. 1994;(1):157-160.
  68. Alton T, Patton DJ, Gee AO. Classifications in Brief: The Hawkins Classification for Talus Fractures. Clin Orthop Relat Res. 2015;473(9):3046-3049.
  69. Buckwalter V JA, Westermann R, Mooers B, Karam M, Wolf B. Timing of Surgical Reduction and Stabilization of Talus Fracture-Dislocations. Am J Orthop (Belle Mead NJ). 2017;46(6):E408-E413.
  70. Srinath SR. Clinical and surgical outcome following surgical management of talar neck fractures. International Journal of Orthopaedics Sciences. 2018;4(1):102-107.
  71. Friberger Pajalic K, Turkiewicz A, Englund M. Update on the risks of complications after knee arthroscopy. BMC Musculoskelet Disord. 2018;19(1):179.
  72. Júnior LH de C, Soares LFM, Gonçalves MBJ, Gomes TP de O, de Oliveira JR, Coelho MG, et al. Tourniquet Versus No Tourniquet Use in Knee Videoarthroscopy: a Multicentric, Prospective, Double-Blind, Randomized Clinical Trial. Rev Bras Ortop. 2010;45(5):415-417.
  73. Zengerink M, van Dijk CN. Complications in ankle arthroscopy. Knee Surg Sports Traumatol Arthrosc. 2012;20(8):1420-1431.

How to Cite

Soetjahjo, B., & Arimuqti, Z. (2021). Current concept management of talus fracture: a literature review. Bali Medical Journal, 10(2), 633–643. https://doi.org/10.15562/bmj.v10i2.2462

HTML
0

Total
19

Share

Search Panel

Bintang Soetjahjo
Google Scholar
Pubmed
BMJ Journal


Zarkasyi Arimuqti
Google Scholar
Pubmed
BMJ Journal