Open Reduction and Internal Fixation for Concomitant Talar Neck, Talar Body, and Medial Malleolar Fractures: A Case Report

Fractures of the talus are rare and generally associated with severe trauma. The mechanism of injury is usually forced dorsiflexion or a fall from a height. Severe talar fractures pose a challenge for surgeons as they are often associated with complications such as avascular necrosis, collapse, malu...

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Main Authors: J Isaacs, B Courtenay, A Cooke, M Gupta
Format: Article
Language:English
Published: SAGE Publishing 2009-04-01
Series:Journal of Orthopaedic Surgery
Online Access:https://doi.org/10.1177/230949900901700125
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author J Isaacs
B Courtenay
A Cooke
M Gupta
author_facet J Isaacs
B Courtenay
A Cooke
M Gupta
author_sort J Isaacs
collection DOAJ
description Fractures of the talus are rare and generally associated with severe trauma. The mechanism of injury is usually forced dorsiflexion or a fall from a height. Severe talar fractures pose a challenge for surgeons as they are often associated with complications such as avascular necrosis, collapse, malunion, secondary osteoarthritis and pain. This has led some institutions to advocate primary arthrodesis for these injuries. We report an unusual complex fracture of the talus that was successfully managed with open reduction and internal fixation. By restoring a near-normal range of motion and function to a fit, young male, the severely limiting effects of arthrodesis were avoided or at least delayed. We use this case to highlight that primary arthrodesis should only be reserved for cases that fail to respond to open reduction and internal fixation or deteriorate to the point where it is the only reasonable and justifiable alternative.
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spelling doaj.art-f647ee04d00e4ebca58079a418b7e08c2022-12-21T17:50:33ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902009-04-011710.1177/230949900901700125Open Reduction and Internal Fixation for Concomitant Talar Neck, Talar Body, and Medial Malleolar Fractures: A Case ReportJ Isaacs0B Courtenay1A Cooke2M Gupta3 The St George Hospital, Sydney, NSW, Australia St Vincent's Hospital, Sydney, NSW, Australia The St George Hospital, Sydney, NSW, Australia St Vincent's Hospital, Sydney, NSW, AustraliaFractures of the talus are rare and generally associated with severe trauma. The mechanism of injury is usually forced dorsiflexion or a fall from a height. Severe talar fractures pose a challenge for surgeons as they are often associated with complications such as avascular necrosis, collapse, malunion, secondary osteoarthritis and pain. This has led some institutions to advocate primary arthrodesis for these injuries. We report an unusual complex fracture of the talus that was successfully managed with open reduction and internal fixation. By restoring a near-normal range of motion and function to a fit, young male, the severely limiting effects of arthrodesis were avoided or at least delayed. We use this case to highlight that primary arthrodesis should only be reserved for cases that fail to respond to open reduction and internal fixation or deteriorate to the point where it is the only reasonable and justifiable alternative.https://doi.org/10.1177/230949900901700125
spellingShingle J Isaacs
B Courtenay
A Cooke
M Gupta
Open Reduction and Internal Fixation for Concomitant Talar Neck, Talar Body, and Medial Malleolar Fractures: A Case Report
Journal of Orthopaedic Surgery
title Open Reduction and Internal Fixation for Concomitant Talar Neck, Talar Body, and Medial Malleolar Fractures: A Case Report
title_full Open Reduction and Internal Fixation for Concomitant Talar Neck, Talar Body, and Medial Malleolar Fractures: A Case Report
title_fullStr Open Reduction and Internal Fixation for Concomitant Talar Neck, Talar Body, and Medial Malleolar Fractures: A Case Report
title_full_unstemmed Open Reduction and Internal Fixation for Concomitant Talar Neck, Talar Body, and Medial Malleolar Fractures: A Case Report
title_short Open Reduction and Internal Fixation for Concomitant Talar Neck, Talar Body, and Medial Malleolar Fractures: A Case Report
title_sort open reduction and internal fixation for concomitant talar neck talar body and medial malleolar fractures a case report
url https://doi.org/10.1177/230949900901700125
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