Minimalinvasive Frakturversorgung des Talus – wann ist sie indiziert?

Abstract

Talus fractures are rare and complex injuries, typically resulting from severe sprains or high-energy trauma, and can lead to significant functional impairment. The primary therapeutic objective is the precise anatomical reduction of the fracture while ensuring maximal preservation of the soft tissue structures. Currently, evidence regarding the optimal management of talus fractures remains limited. In addition to open surgical approaches, minimally invasive techniques are increasingly being recognized as a promising alternative.

This review outlines the various minimally invasive access routes for mini-open or arthroscopic treatment, highlighting their application and the advantages they offer over conventional open surgical procedures. Minimally invasive techniques offer substantial benefits in terms of preserving soft tissue integrity and the blood supply to the talus, thereby reducing the risk of complications. These approaches are particularly indicated for fractures with minimal displacement.

In contrast, severely displaced fractures are typically managed through large open approaches, but can be more effectively addressed with a tissue-preserving arthroscopic technique. Arthroscopy not only facilitates precise fracture reduction but also provides versatile treatment options for concomitant osteochondral lesions.

Thus, in the surgical management of talus fractures, soft tissue-sparing, minimally invasive approaches should be considered as a first-line option to optimize functional outcomes while minimizing the risk of complications.