Review of talar neck fractures among in patient cases in Ahvaz Imam Khomeini hospital: A ten years study

In spit of advances of our knowledge of bone biology, blood supply and surgical techniques, talus fracture, a rare condition, is one of the most problematic fractures of foot and ankle region is still associated with a high rate of complication. The aim of this study was to assess its prevalence in our region. Iam Khomeini Hospital Ahvaz, Iran over 10 years (during 995-2005). The demographic characn this retrospective study carried out on 20 000 in-patient files in the Orthopedic Department of Imteristics of patients suffering from talus fracture, as well as the type, cause and treatment options undertaken were also reviewed.Twenty eight of talar neck farctures were found in 27 patients. Twenty five cases (89%) in men and 3 cases (11%) in women. A bilateral case was found in a 17 years old female teenager. Mean age of the patients was 31 years and 17 cases (61%) occurred in the right side and 11 (39%) cases occurred in left side. Most common cause of talar neck fracture were vehicle accident (53.6%), fall from height (32.1%), motor bike slipping (10.7%) and gun shot injury (3.6%). The types of talus fracture, according to modified Hawkins classification were as following: Type 2 (35.7%), type 3 (32.2%), type 1 (21.4%), type 4 (10.7%). Four cases had open fractures (34.3%) and 19 (68%) cases had an extra fractures as well as talar neck fracture. The most common accompanying fracture was medial malolous fracture in 12 (43%) cases and calcaneous fracture in 2 (14.3%). Posterior tibialis nerve injury was found in two patients and peroneal nerve injury was found in one patient. Sixty eight % of patients were treated with open reduction with or without internal fixation and 28.6% of patients were treated with closed reduction and casting. One case was treated with applying skeletal traction to the calcaneous.Talar neck fracture is rare lesion with a male/female ratio of 8:1 in our region. The most common type of fracture is type 2 caused primarily by vehicle accidents and fall from height. The most common accompanying fracture was medial maleolous and calcaneous fractures. Peroneal nerve injury was not reported before in a review of article but found in one patient.