Chirurgie orthopédique et traumatologie, Centre Hospitalier Inter-communal Toulon/La Seyne, 54 Rue Henri Sainte-Claire Deville, 83100 Toulon, France.
Clinique du Cèdre, 950 rue de la Haie, 76230 Bois Guillaume, France.
Orthop Traumatol Surg Res. 2021 Oct;107(6):102835. doi: 10.1016/j.otsr.2021.102835. Epub 2021 Jan 30.
Talar fracture is rare. Treatment is surgical for neck and/or body fractures with displacement. The aims of the present study were to collect epidemiological data on talar fractures, and to assess the impact of trauma via various functional scores and radiographic impact in the medium term.
Displaced talar fracture shows negative medium-term functional and radiological/clinical impact.
A multicenter retrospective study was performed with a minimum follow-up of 12 months post-trauma. Inclusion criteria included radiographic assessment at a minimum 12 months post-trauma and data on 3 functional scores: SF12, AOFAS and FAAM. 225 patients were initially included, 81 of whom had follow-up with functional and radiological/clinical assessment.
Fracture reduction was anatomic in 61% of cases when CT was performed; reduction quality was independent of approach (p>0.05). 45% of patients showed subtalar osteoarthritis at a mean 2 years, significantly related to reduction defect (p<0.05). Mean AOFAS score was acceptable, at 74/100. Factors for functional prognosis comprised: reduction quality, hindfoot alignment, subtalar osteoarthritis, and talar osteonecrosis with dome collapse.
Talar fracture led to late complications with socioeconomic impact. Subtalar osteoarthritis affects almost half of patients within some months of trauma. Optimal reduction is the key to fair progression. Postoperative CT assessment now seems mandatory.
IV; multicenter retrospective study.
距骨骨折较为罕见。对于有移位的颈部和/或体部骨折，治疗方法为手术。本研究的目的是收集距骨骨折的流行病学数据，并通过各种功能评分和中期影像学评估来评估创伤的影响。
有移位的距骨骨折在中期会产生负面的功能和影像学/临床影响。
这是一项多中心回顾性研究，随访时间至少为创伤后 12 个月。纳入标准包括至少在创伤后 12 个月的影像学评估以及 3 项功能评分（SF12、AOFAS 和 FAAM）的数据。最初纳入了 225 例患者，其中 81 例患者进行了功能和影像学/临床评估随访。
当进行 CT 检查时，61%的病例骨折复位达到解剖学复位；复位质量与入路无关（p>0.05）。45%的患者在平均 2 年内出现距下关节炎，与复位缺陷显著相关（p<0.05）。AOFAS 评分的平均值尚可，为 74/100。功能预后的因素包括：复位质量、后足对线、距下关节炎和距骨穹隆塌陷性骨坏死。
距骨骨折导致了具有社会经济影响的晚期并发症。距下关节炎几乎影响一半的患者，在创伤后几个月内就会出现。理想的复位是良好进展的关键。术后 CT 评估现在似乎是必要的。
IV；多中心回顾性研究。
