Clinical Research
Operative treatment of Sneppen Ⅴ talus fracture through approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation
Hao Zengtao, Wang Xiaolong, Yin Chao, Wang Jihong, Wen Shuzheng, Fan Dongsheng, Wang Yongfei, Jiang Dong, Zhang Guorong
Published 2019-10-15
Cite as Chin J Orthop Trauma, 2019,21(10): 910-913. DOI: 10.3760/cma.j.issn.1671-7600.2019.10.016
Abstract
ObjectiveTo report the effects of operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation.
MethodsFrom January 2015 to January 2019, 16 patients with Sneppen Ⅴ talus fracture were treated at Department Ⅱ of Hand & Foot Microsurgery, The Second Affiliated Hospital to Inner Mongolia Medical University. They were 14 men and 2 women with a mean age of 38.4 years (range, from 20 to 55 years). All fractures were fixed with hollow compression screws through the approach for malleolus medialis Ⅴ osteotomy. The ankle and hindfoot functional scoring system developed by American Orthopaedic Foot and Ankle Society (AOFAS) was used to evaluate the clinical outcomes.
ResultsAll patients were followed up for a mean time of 12.6 months (range, from 6 to 30 months). The mean operation time was 68.4 minutes (range, from 52 to 96 minutes); the mean amount of hemorrhage during operation was 96.8 mL (range, from 48 to 122 mL); the mean period of bone union was 4.8 months (range, from 3 to 8 months). The postoperative mean AOFAS score was 75.3 points (range, from 43 to 91 points). Complications occurred in 4 cases, including one case of talus ischemic necrosis, one case of partial talus ischemic necrosis accompanied by tibial arthritis, one case of subtalar arthritis, and one case of combined tibial, talar and subtalar arthritis. All incisions obtained primary healing, with no complications like infection, screw breakage, delayed union or nonunion.
ConclusionOperative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation can provide sufficient operative exposure to facilitate reduction and fixation of the talus fracture so that the ischemic necrosis of the talus and traumatic arthritis can be effectively reduced.
Key words:
Talus; Fractures, bone; Fracture fixation, internal; Bone nails; Malleolus medialis osteotomy
Contributor Information
Hao Zengtao
Department Ⅱ of Hand & Foot Microsurgery, The Second Affiliated Hospital to Inner Mongolia Medical University, Hohhot 010030, China
Wang Xiaolong
Yin Chao
Wang Jihong
Wen Shuzheng
Fan Dongsheng
Wang Yongfei
Jiang Dong
Zhang Guorong