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KMID : 1130920080120020163
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Journal of Korean Foot and Ankle Society
2008 Volume.12 No. 2 p.163 ~ p.167
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Avascular Necrosis after Operative Treatment for Fracture and Dislocations of the Talar Neck
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Kong Il-Kyu
Seo Hyoung-Yeon
Lee Keun-Bae
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Abstract
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Purpose: To evaluate the incidence of avascular necrosis (AVN), prognostic reliability of the Hawkins sign, and clinical outcomes after operative treatment of fracture and dislocations of the talar neck.
Materials and Methods: We analysed 16 patients with fracture and dislocations of the talar neck which were treated by open reduction and internal fixation and followed up for more than 2 years. The postoperative radiographs were examined for Hawkins sign and avascular necrosis was confirmed by bone scan. The assessment of clinical results was based on the Hawkins scoring system.
Results: AVN was occurred in 2 of 16 cases (12.5%) only in type III. Hawkins sign was found 11 of 16 cases (68.8%), which included 8 cases in type II, 2 cases in type III and 1 case in type IV. The Hawkins sign was not observed in two cases with AVN. In contrast, only 2 of the 5 cases with a negative Hawkins sign developed AVN. According to Hawkins scoring system, 4 patients (25.0%) was in excellent, 7 patients (43.8%) in good, 4 patients (25.0%) in fair and 1 patient (6.3%) in poor.
Conclusion: Incidence of AVN after operative treatment of fracture and dislocations of the talar neck was lower than that of previous reports. Hawkins sign had a high prognostic reliability, but absence of Hawkins’ sign should not be considered a totally reliable indicator of development of avascular necrosis.
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KEYWORD
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Talar neck, Fracture and dislocations, Hawkins sign, Avascular necrosis
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