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KMID : 1130920100140010079
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Journal of Korean Foot and Ankle Society
2010 Volume.14 No. 1 p.79 ~ p.83
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Screw Fixation Techniques for Talar Neck Fractures (Anterior versus Posterior insertion)
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Shin Dong-Eun
Yoon Hyung-Ku
Choi Woo-Jin
Lee Yun-Seok
Han Seung-Chul
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Abstract
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Purpose: To compare the clinical and radiological results between the anterior and posterior screw fixation for the treatment of talar neck fracture.
Materials and Methods: Among 30 patients who received surgical treatment for talar neck fracture from 2001 to 2008. Twenty-seven patients with a follow-up period of more than 1 year were divided into two groups. Twelve patients were treated with anterior screw fixation and 15 patients with posterior approaches. We analyzed preoperative, postoperative and follow-up radiographs. Clinical results were evaluated by Hawkins criteria.
Results: The posteriorly inserted screws were placed across the more central portion of the talar neck and perpendicular to the plane of fracture (p<0.05). There were no difference in clinical results, the duration of union, and complications including avascular necrosis between two groups. However, 2 patients complained of pain around the talonavicular joint in the anterior insertion group.
Conclusion: Although the clinical results were good irrespective of insertion methods, the posterior approach of screw fixation for talar neck fractures allows for a better mechanical advantage than anterioly placed screws. This may allow early motion with a reduced risk of failure of fixation or of displacement of the fracture.
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KEYWORD
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Talus, Neck fracture, Anterior and posterior approach, Screw fixation
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