Jordan Richard K, Bafna Kunaal R, Liu Jiayong, Ebraheim Nabil A
Medical Student, College of Medicine and Life Sciences, University of Toledo, Toledo, OH.
Orthopedist and Assistant Professor, Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, OH.
J Foot Ankle Surg. 2017 Jul-Aug;56(4):817-821. doi: 10.1053/j.jfas.2017.04.013.
The goal of the present study was to perform a systematic review of the published data on talar neck fractures for a better understanding of the postoperative clinical outcomes using open reduction and internal fixation stratified by Hawkins type. A PubMed search was performed using the keywords "talar," "neck," and "fracture." This search identified 209 potential studies, which were reviewed to yield 16 studies that met the criteria. The surgical outcomes of talar neck fractures stratified by the Hawkins classification analyzed in the present study were as follows: American Orthopaedic Foot and Ankle Society scale score was 77.00 for type I, 86.10 for type II, 68.30 for type III, 68.30 for type IV, and 76.50 for all talar neck fractures. Avascular necrosis presented in 0.00% of type I fractures, 15.91% of type II fractures, 38.89% of type III fractures, 55.00% of type IV fractures, and 26.47% of all fractures. Osteoarthritis presented in 25.00% of type I fractures, 41.33% of type II fractures, 54.23% of type III fractures, 72.73% of type IV fractures, and 51.69% of all fractures. Subtalar arthritis presented in 0.00% of type I fractures, 54.29% of type II fractures, 46.43% of type III fractures, 45.45% of type IV fractures, and 44.97% of all fractures. The malunion prevalence was 13.29% and the nonunion prevalence was 3.97% for all fractures. Type II fractures were the most common (50.88%) fracture type reported in the reports reviewed in the present study.
本研究的目的是对已发表的距骨颈骨折数据进行系统评价，以便更好地了解采用切开复位内固定术并按霍金斯分型分层后的术后临床结果。使用关键词“距骨”“颈部”和“骨折”在PubMed上进行检索。该检索识别出209项潜在研究，经审查后有16项研究符合标准。本研究中按霍金斯分类分层分析的距骨颈骨折手术结果如下：I型骨折的美国矫形足踝协会量表评分为77.00，II型为86.10，III型为68.30，IV型为68.30，所有距骨颈骨折为76.50。I型骨折的缺血性坏死发生率为0.00%，II型为15.91%，III型为38.89%，IV型为55.00%，所有骨折为26.47%。骨关节炎发生率在I型骨折中为25.00%，II型为41.33%，III型为54.23%，IV型为72.73%，所有骨折为51.69%。距下关节炎发生率在I型骨折中为0.00%，II型为54.29%，III型为46.43%，IV型为45.45%，所有骨折为44.97%。所有骨折的畸形愈合发生率为13.29%，不愈合发生率为3.97%。II型骨折是本研究中所审查报告中最常见的骨折类型（50.88%）。
