Whitaker Colin, Turvey Blake, Illical Emmanuel M
Department of Orthopedic Surgery, Einstein Healthcare Network, 5501 Old York Road, WCB4, Philadelphia, PA, 19141, USA.
Curr Rev Musculoskelet Med. 2018 Sep;11(3):456-474. doi: 10.1007/s12178-018-9509-9.
Talar neck fractures are a rare but potentially devastating injury, which require a comprehensive understanding of the unique osteology, vasculature, and surrounding anatomy to recognize pathology and treat correctly. The purpose of this article is to describe both classic and current literature to better understand the evolution of talar neck fracture management.
Urgent reduction of displaced fractures and dislocations remains the standard of care to protect the soft tissue envelope and neurovascular structures. Delayed definitive fixation has proven to be safe. CT is the imaging modality of choice to fully identify the fracture pattern and associated injuries. Anatomic reduction and restoration of the peritalar articular surfaces are the pillars of talar neck fracture treatment. Dual incision approach with plate and screw fixation has become the modern surgical strategy of choice to accomplish these goals. Although complications such as osteonecrosis (ON) and posttraumatic arthritis (PTA) can still occur at high rates, treatment should be dictated by patient symptoms. Talar neck fractures pose treatment challenges with both initial injury and potential sequelae. Future research will determine whether modern treatment algorithms will decrease complication rate and improve patient outcome.
距骨颈骨折虽罕见但可能极具破坏性，需要全面了解其独特的骨学、血管系统及周围解剖结构，以识别病变并正确治疗。本文旨在描述经典及当前文献，以更好地理解距骨颈骨折治疗的演变。
紧急复位移位骨折和脱位仍是保护软组织包膜及神经血管结构的标准治疗方法。延迟确定性固定已被证明是安全的。CT是全面识别骨折类型及相关损伤的首选影像学检查方法。距骨颈骨折治疗的关键是解剖复位和恢复距骨周围关节面。双切口钢板螺钉固定法已成为实现这些目标的现代首选手术策略。尽管骨坏死（ON）和创伤后关节炎（PTA）等并发症仍可能高发，但治疗应根据患者症状决定。距骨颈骨折在初始损伤及潜在后遗症方面均带来治疗挑战。未来研究将确定现代治疗方案是否会降低并发症发生率并改善患者预后。
