#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Ankle Fractures in Children


Authors: P. Kľoc;  J. Harčarík *
Authors‘ workplace: Oddelenie úrazovej chirurgie, FNsP J. A. Reimana, Prešov, Slovenská republika, primár: MUDr. J. Bujňák ;  Ambulancia úrazovej chirurgie, HOLGER Slovakia s. r. o. Prešov, Slovenská republika *
Published in: Rozhl. Chir., 2011, roč. 90, č. 6, s. 365-370.
Category: Monothematic special - Original

Overview

In the present work we address the issue of rare childhood bone fractures of the talus.

In the study, we retrospectively analyzed a group of pediatric patients with fractures of the talus treated in the space of 10 years at two workplaces of trauma surgery. Patients were evaluated clinically and radiographically with at least one year follow-up.

Fourteen patients with a mean age of 12 years met the methodological criteria. All suffered low-energy trauma. According to Marti-Weber classification six of them suffered central fracture of the talus. Of these, two were treated by closed reduction and internal fixation. The other patients were treated conservatively. In one patient we observed the presence of Hawkins’ sign. We observed only minor complications in patients with peripheral fractures of the talus. Hawkins’ overall average score of our patients was 15 points.

The discussion is a comparison of some aspects of fractures of the talus in children and adults. We also note the discrepancies in the conclusions of several authors dealing with the issue of pediatric talar fractures. We specialize in central talus fractures, mechanisms of their origin, their optimal treatment and the issue of factors affecting the emergence of avascular necrosis of the talus.

The absence of serious complications in our series of patients may be due to their low numbers, early definitive treatment, or the nature of their fractures. Good therapeutic results may be also due to the lower tendency for developing complications after talar fractures in pediatric patients. In the absence of relevant data in the literature we can accept with certainty only that fracture of the talus in a child should not be overlooked and should be treated according to principles that adhere to the treatment of fractures of the talus in adults, followed by long – term dispensary.

Key words:
fractures of talus – children – avascular necrosis


Sources

1. Linhart, W. E., Hollwarth, M. Talus frakturen bei Kindern. Unfallchirurg, 1985; 88(4): 168–174.

2. Smith, J. T., Curtis, T. A., Spencer, S., Kasser, J. R., Mahan, S. T. Complications of talus fractures in children. J. Pediatr. Orthop., 2010; 30(8): 779–784.

3. Canale, S. T., Kelly, F. B. Jr.: Fractures of the neck of the talus. Long-term evaluation of seventy – one cases. J. Bone Joint Surg. Am., 1978; 60: 143–156.

4. Hawkins, L. Fractures of the neck of the talus. J. Bone Joint Surg., 1970; 52A: 991–1002.

5. Kirkpatrick, D. P., Hunter, R. E., Janes, P.C., Mastrangelo, J., Nicholas, R. A. The snowboarder‘s foot and ankle. Am. J. Sports Med., 1988; 26: 271–277.

6. Crim, J. Talus fractures [online]. 2008–12–30 [cit. 2009–10–20]. Dostupné na: http://emedicine. medscape.com/article/396568-overview

7. Sneppen, O., Christensen S. B., Krogsoe, O., Lorentzen, J. Fracture of The Body of The Talus. Acta Orthop. Scand., 1977; 48: 317–324.

8. Berndt, A. L., Harty, M. Transchondral fractures (osteochondritis dissecans) of the talus. J. Bone Joint Surg., 1959; 41A: 988–1020.

9. Ribbans, W. J., Natarajan, R., Alavala. S. Pediatric foot fractures. Clin. Orthop. Relat. Res., 2005; 432: 107–115.

10. Jensen, J., Wester, J., Rasmussen, F., Lindequist, S., Schantz, K. Prognosis of fracture of the talus in children. 21 (7–34) – year follow-up of 14 cases. Acta Orthop. Scand., 1994; 65: 398–400.

11. Mazel, C., Rigault, P., Padovani, J. P., Finidori, G., Touzet, P. Fractures of the talus in children. Apropos of 23 cases. Rev. Chir. Orthop. Reparatrice Appar. Mot., 1986; 72(3): 183–195.

12. Draijer, F., Havemann, D., Bielstein, D. Verletzungsanalyse kindlicher talusfrakturen. Unfallchirurg, 1995; 98(3): 130–132.

13. Eberl, R., Singer, G., Schalamon, J., Hausbrandt, P., Hoellwarth, E. Fractures of the talus – differences between children and adolescents. J. Trauma, 2010; 68(1): 126–130.

14. Rammelt, S., Zwipp, H., Gavlik, J. M. Avascular necrosis after minimally displaced talus fracture in a child. Foot Ankle Int., 2000; 12: 1030–1036.

15. Gehr, J., Friedl, W. Talushalsfraktur beim Kind. Unfallchirurg, 2006; 109(10): 910–913.

16. Yazdi, H., Ramezan, S. M. An unusual presentation of talus fracture in a child: a case report. J. Foot Ankle Surg., 2010; 16(3): e57–60.

17. Meier, R., Krettek, C., Griensven, M., Chawda, M., Thermann, H. Fractures of the talus in the pediatric patient. Foot and Ankle Surgery, 2005; 11: 5–10.

18. Cartwright-Terry, M., Pullen, H.: Non-operative management of a talar body fracture in a skeletally immature patient. Acta Orthop. Belg., 2008; 7: 137–140.

19. Schwarz, N., Gebauer, M. Die Fraktur des Sprungbeines beim Kind. Unfallheilkunde, 1983; 86(5): 212–221.

20. Lutz, M., Golser, K., Sperner, G., Gabl, M., Wambacher, M., Sailer, R. Die posttraumatische durchblutungsstörung des talus. Ist die talusnekrose obligat? Unfallchirurg, 1998; 101(6): 461–467.

21. Talkhani, I. S., Reidy, D., Fogarty, E. E., Dowling, F. E., Moore, D. P. Avascular necrosis of the talus after a minimally displaced neck of talus fracture in a 6 year old child. Injury, 2000; 31: 63–65.

22. McKeever, F. M. Fractures of the neck of the astragalus. Arch. Surg., 1943; 46: 720–735.

23. Vallier, H. A., Nork, S. E., Barei, D. P., Benirschke, S. K., Sangeorzan, B. J. Talar neck fractures: results and outcomes. J. Bone Joint Surg., 2004; 86A(8): 1616–1624.

Labels
Surgery Orthopaedics Trauma surgery
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#