[Mid-term efficacy of lateral malleolar osteotomy approach combined with bioabsorbable pins fixation for the treatment of talar body fracture].

Abstract

Objective: To explore surgical technique and mid-term efficacy of treating talar body fractures through lateral malleolus osteotomy approach with absorbable rod fixation.

Methods: From January 2021 to April 2023, clinical data of 25 patients with talar body fractures who underwent anatomical reduction with absorbable rods via the lateral malleolus osteotomy were retrospectively analyzed, included 15 males and 10 females;aged from 20 to 54 years old with an average of (34.3±8.2) years;8 patients were typeⅡand 17 patients were type Ⅲ according to Sneppen classification of talar body fractures. Fracture healing time, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS), and the occurrence of complications were evaluated.

Results: All 25 patients were followed up after operation, the follow-up period ranged from 24 to 52 months with average of(35.7±6.5) months. All patients were achieved fracture healing, and the healing time ranged from 12 to 18 weeks with an average of(15.1±1.7) weeks. AOFAS ankle-hindfoot score increased from (45.28±4.41) points before operation to (88.96±5.19) points at 2 years after operation;13 feet were excellent, 9 feet were good, and 3 feet were fair. VAS decreased from 8.0 (7.0, 9.0) points before operation to 2.0 (1.0, 2.5) points at 2 years after operation, and the differences at each follow-up time point were statistically significant(P<0.05). The imaging examinations showed all patients had good healing of talus body fractures and the osteotomy sites. The absorbable rods gradually degraded over a period of 20 to 24 months after operation, without any failure or displacement of internal fixation. No traumatic arthritis or talus necrosis occurred.

Conclusion: The lateral malleolus osteotomy approach could provide a good surgical field, and achieve satisfactory reduction results for talus body fractures combined with absorbable rods for fixation. The postoperative functional recovery is satisfactory, and it avoids the need for secondary surgery to remove internal fixation. The mid-term efficacy is also good.