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Talar Neck Fractures With Associated Ipsilateral Foot and Ankle Fractures Have a Higher Risk of Avascular Necrosis.
- Source :
-
Journal of orthopaedic trauma [J Orthop Trauma] 2024 Jun 01; Vol. 38 (6), pp. 220-224. - Publication Year :
- 2024
-
Abstract
- Objectives: To determine if talar neck fractures with concomitant ipsilateral foot and/or ankle fractures (TNIFAFs) are associated with higher rates of avascular necrosis (AVN) compared with isolated talar neck fractures (ITNs).<br />Design: Retrospective cohort.<br />Setting: Single level I trauma center.<br />Patient Selection Criteria: Skeletally mature patients who sustained talar neck fractures from January 2008 to January 2017 with at least 6-month follow-up. Based on radiographs at the time of injury, fractures were classified as ITN or TNIFAF and by Hawkins classification.<br />Outcome Measures and Comparisons: The primary outcome was the development of AVN based on follow-up radiographs, with secondary outcomes including nonunion and collapse.<br />Results: There were 115 patients who sustained talar neck fractures, with 63 (55%) in the ITN group and 52 (45%) in the TNIFAF group. In total, 63 patients (54.7%) were female with the mean age of 39 years (range, 17-85), and 111 fractures (96.5%) occurred secondary to high-energy mechanisms of injury. There were no significant differences in demographic or clinical characteristics between groups ( P > 0.05). Twenty-four patients (46%) developed AVN in the TNIFAF group compared with 19 patients (30%) in the ITN group ( P = 0.078). After adjusting for Hawkins classification and other variables, the odds of developing AVN was higher in the TNIFAF group compared with the ITN group [odds ratio, 2.43 (95% confidence interval, 1.01-5.84); ( P = 0.047)].<br />Conclusions: This study found a significantly higher likelihood of AVN in patients with talar neck fractures with concomitant ipsilateral foot and/or ankle fractures compared to those with isolated talar neck fractures after adjusting for Hawkins classification and other potential prognostic confounders.<br />Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.<br />Competing Interests: The authors report no conflict of interest.<br /> (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
- Subjects :
- Humans
Female
Male
Adult
Retrospective Studies
Middle Aged
Aged
Adolescent
Young Adult
Aged, 80 and over
Risk Factors
Cohort Studies
Talus injuries
Talus diagnostic imaging
Ankle Fractures complications
Ankle Fractures surgery
Osteonecrosis etiology
Fractures, Bone complications
Fractures, Bone diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1531-2291
- Volume :
- 38
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of orthopaedic trauma
- Publication Type :
- Academic Journal
- Accession number :
- 38457751
- Full Text :
- https://doi.org/10.1097/BOT.0000000000002798