Other Foot Fractures
FRACTURES
1. fractures (50%)
Classification
Hawkins "Fractures of the neck of the talus" JBJS 52A:991-1002, 1970
Type
|
Pathology
|
I
|
Undisplaced
|
II
|
Displaced [disloc. subtalar jt.]
|
III
|
Displaced + dislocation of the body [disloc. ankle jt.]
|
IV
|
Displaced + dislocation of both body and neck (added by Terry and Canale later) [disloc. T-N jt.]
|
Treatment and results
Hawkins |
Treatment |
AVN |
Non-union |
Subtalar Arthrosis |
Results |
Type I |
6 weeks non-weight bearing in cast (minimum), weight bearing starts when signs of union present |
10% |
2% |
25% |
90% good results |
Type II |
Immediate closed reduction in A/E if skin compromise present, ORIF via medial approach with lag screw fixation from anterior - posterior. The screw heads must be countersunk below the articular surface. |
40% |
8% |
65% |
47% unsatisfactory result with healing usually in 8 - 12 weeks |
Type III |
25% of these are open; ORIF required (via medial malleolus osteotomy) |
90% |
10% |
65% (ankle 70%) |
Malunion 30%; 52% unsatisfactory results and healing occurs in upward of 16 weeks |
Type IV |
ORIF |
This is a preview of the site content. To view the full text for this site, you need to log in. If you are having problems logging in, please refer to the login help page.
|