Κατάγματα Αστραγάλου
DESCRIPTION
Κατάγματα ΑστραγάλουTRANSCRIPT
![Page 1: Κατάγματα Αστραγάλου](https://reader034.vdocuments.mx/reader034/viewer/2022042823/568bda571a28ab2034aa716d/html5/thumbnails/1.jpg)
A.X.Papadopoulos, M.Tyllianakis, E. Lambiris
EVALUATION AND TREATMENT OF
TALAR FRACTURES
Orthopeadic Department of Patras University
Head: Prof. E. Lambiris
ORTHO PATRAS
![Page 2: Κατάγματα Αστραγάλου](https://reader034.vdocuments.mx/reader034/viewer/2022042823/568bda571a28ab2034aa716d/html5/thumbnails/2.jpg)
TALAR FRACTURES:
Dorsiflexion (extension) is the main
mechanism of injury
3% of all foot fractures
Arthritis is common: 70% of talus
surface is covered by cartilage
High likelihood of vascular interruption
ORTHO PATRAS
![Page 3: Κατάγματα Αστραγάλου](https://reader034.vdocuments.mx/reader034/viewer/2022042823/568bda571a28ab2034aa716d/html5/thumbnails/3.jpg)
PATIENTS
12 (52,2%) multi-injured patients
Between 1992 and 2000, 25 patients with
talus fractures were treated
Mean age 31,8 y (16 - 64 y)
Follow-up: 23 patients [20 men-3 women]
ORTHO PATRAS
![Page 4: Κατάγματα Αστραγάλου](https://reader034.vdocuments.mx/reader034/viewer/2022042823/568bda571a28ab2034aa716d/html5/thumbnails/4.jpg)
ΜΗΧΑΝΙΣΜΟΣ ΚΑΚΩΣΗΣ
15
8
Τροχαίο ατύχημα
Πτώση από ύψος
65,2%
34,7%
ORTHO PATRAS
![Page 5: Κατάγματα Αστραγάλου](https://reader034.vdocuments.mx/reader034/viewer/2022042823/568bda571a28ab2034aa716d/html5/thumbnails/5.jpg)
Talar neck fracture 15 patients (65,2%)
CLASSIFICATION:
A B
C D
(Hawkins 1970 - Canale and Kelly’s modification 1978)
![Page 6: Κατάγματα Αστραγάλου](https://reader034.vdocuments.mx/reader034/viewer/2022042823/568bda571a28ab2034aa716d/html5/thumbnails/6.jpg)
Talar body fracture(shearing) :
4 patients (17,4%)
Talar head fracture:
1 patient
Talar process fracture :3 patients
(13,1%)-posterior tubercle ORTHO PATRAS
![Page 7: Κατάγματα Αστραγάλου](https://reader034.vdocuments.mx/reader034/viewer/2022042823/568bda571a28ab2034aa716d/html5/thumbnails/7.jpg)
RADIOLOGICAL EVALUATION
Foot-Ankle in 15% inversion
Talus CT (saggital,tranverse and coronal)
Foot-Ankle F+P
ORTHO PATRAS
![Page 8: Κατάγματα Αστραγάλου](https://reader034.vdocuments.mx/reader034/viewer/2022042823/568bda571a28ab2034aa716d/html5/thumbnails/8.jpg)
Surgical treatment : 18 patients
TREATMENT
ORTHO PATRAS
![Page 9: Κατάγματα Αστραγάλου](https://reader034.vdocuments.mx/reader034/viewer/2022042823/568bda571a28ab2034aa716d/html5/thumbnails/9.jpg)
Excellent: 11 patients
(47,8%)
Good: 5 patients
(21,7%)
Moderate: 3 patients
(16,6%)
Poor: 4 patients
(17,4%)
RESULTS
Mean folow-up : 58 months (12 months - 9 years)
FUNCTION (40)
GAIT (10)
RANGE OF MOTION (10)
SUMMARY (100)
Iowa Ankle evaluation score
FREEDOM FROM PAIN (40)
ORTHO PATRAS
![Page 10: Κατάγματα Αστραγάλου](https://reader034.vdocuments.mx/reader034/viewer/2022042823/568bda571a28ab2034aa716d/html5/thumbnails/10.jpg)
2
2 1 1
5 1 1
0% 20% 40% 60% 80% 100%
poor
moderate
good
excellent
A
B
C
D
NECK # RESULTS
ORTHO PATRAS
![Page 11: Κατάγματα Αστραγάλου](https://reader034.vdocuments.mx/reader034/viewer/2022042823/568bda571a28ab2034aa716d/html5/thumbnails/11.jpg)
1 1
1
1
2
0% 20% 40% 60% 80% 100%
poor
moderate
good
excellent
body
process
BODY-PROCESS-HEAD # RESULTS
ORTHO PATRAS
![Page 12: Κατάγματα Αστραγάλου](https://reader034.vdocuments.mx/reader034/viewer/2022042823/568bda571a28ab2034aa716d/html5/thumbnails/12.jpg)
COMPLICATIONS
Arthritis
Avascular necrosis: 1 patient
Subtalar: 6 patients
Ankle: 2 patients
ORTHO PATRAS
![Page 13: Κατάγματα Αστραγάλου](https://reader034.vdocuments.mx/reader034/viewer/2022042823/568bda571a28ab2034aa716d/html5/thumbnails/13.jpg)
Α.H. 19 years old,
neck # type A
and posterior
tubercle #
3/12 PO
6 /12 PO
ORTHO PATRAS
![Page 14: Κατάγματα Αστραγάλου](https://reader034.vdocuments.mx/reader034/viewer/2022042823/568bda571a28ab2034aa716d/html5/thumbnails/14.jpg)
Κ.D. 64 y
neck #
type D
ORTHO PATRAS
![Page 15: Κατάγματα Αστραγάλου](https://reader034.vdocuments.mx/reader034/viewer/2022042823/568bda571a28ab2034aa716d/html5/thumbnails/15.jpg)
3 years PO
Κ.D. PO
ORTHO PATRAS
![Page 16: Κατάγματα Αστραγάλου](https://reader034.vdocuments.mx/reader034/viewer/2022042823/568bda571a28ab2034aa716d/html5/thumbnails/16.jpg)
P.T. 31y
body #
ORTHO PATRAS
![Page 17: Κατάγματα Αστραγάλου](https://reader034.vdocuments.mx/reader034/viewer/2022042823/568bda571a28ab2034aa716d/html5/thumbnails/17.jpg)
P.T. 1,5 y PO
ankle arthritis-arthrodesis
ORTHO PATRAS
![Page 18: Κατάγματα Αστραγάλου](https://reader034.vdocuments.mx/reader034/viewer/2022042823/568bda571a28ab2034aa716d/html5/thumbnails/18.jpg)
P.N. 25y, head #
4y PO
ORTHO PATRAS
![Page 19: Κατάγματα Αστραγάλου](https://reader034.vdocuments.mx/reader034/viewer/2022042823/568bda571a28ab2034aa716d/html5/thumbnails/19.jpg)
H.B. 59y, neck # type B1,5 m PO
ORTHO PATRAS
![Page 20: Κατάγματα Αστραγάλου](https://reader034.vdocuments.mx/reader034/viewer/2022042823/568bda571a28ab2034aa716d/html5/thumbnails/20.jpg)
H.B. 5m PO
ORTHO PATRAS
![Page 21: Κατάγματα Αστραγάλου](https://reader034.vdocuments.mx/reader034/viewer/2022042823/568bda571a28ab2034aa716d/html5/thumbnails/21.jpg)
CONCLUSION
Immediated anatomical reduction with
internal fixation is essential for good results
after talus fractures
Undisplaced talus fractures can be treared
conservatively by immobilization and
close observation
Internal fixation using Herbert screw may
be a good alternative solution
ORTHO PATRAS