Zugangswege zur Talusfraktur – Kann der ventrale Zugang bilaterale Zugänge ersetzen?

Abstract

Talus fractures are among the most complex injuries in the lower extremity. Overall, they are a rare injury and account for only approx. 0.3–0.5% of all fractures and approx. 3–4% of fractures of the foot. They mainly affect young adults (third decade of life) in a ratio of 3:1 between men and women. Due to the specific anatomical, biomechanical and vascular characteristics of the talus, surgical treatment is challenging. The correct choice of the surgical approach is crucial in order to achieve anatomical reduction of the fracture and good long term function.

Traditionally, bilateral approaches are used for complex talus fractures, exposing both the the medial and lateral side of the talus. Establishing the ventral approach allows direct visualization of the caput and the colum ventrally. However, the question arises as to whether this method can represent a less invasive invasive alternative to the traditional bilateral approaches.

In summary, the evidence suggests that the ventral approach may be a useful alternative to bilateral approaches for certain indications, particularly isolated fractures of the talar neck. However, bilateral approaches remain the gold standard for complex, multidirectional fractures. The choice of the surgical approaxch should nevertheless always be individually based on fracture complexity, patient characteristics and surgical expertise.