Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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Avascular Necrosis after Operative Treatment for Fracture and Dislocations of the Talar Neck

거골 경부 골절 및 탈구의 수술적 치료 후 발생한 무혈성 괴사

  • Kong, Il-Kyu (Department of Orthopaedic Surgery, Chonnam National University Medical School and Hospital) ;
  • Seo, Hyoung-Yeon (Department of Orthopaedic Surgery, Chonnam National University Medical School and Hospital) ;
  • Lee, Keun-Bae (Department of Orthopaedic Surgery, Chonnam National University Medical School and Hospital)
  • 공일규 (전남대학교 의과대학 정형외과학교실) ;
  • 서형연 (전남대학교 의과대학 정형외과학교실) ;
  • 이근배 (전남대학교 의과대학 정형외과학교실)
  • Published : 2008.12.01
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Abstract

Purpose: To evaluate the incidence of avascular necrosis (AVN), prognostic reliability of the Hawkins sign, and clinical outcomes after operative treatment of fracture and dislocations of the talar neck. Materials and Methods: We analysed 16 patients with fracture and dislocations of the talar neck which were treated by open reduction and internal fixation and followed up for more than 2 years. The postoperative radiographs were examined for Hawkins sign and avascular necrosis was confirmed by bone scan. The assessment of clinical results was based on the Hawkins scoring system. Results: AVN was occurred in 2 of 16 cases (12.5%) only in type III. Hawkins sign was found 11 of 16 cases (68.8%), which included 8 cases in type II, 2 cases in type III and 1 case in type IV. The Hawkins sign was not observed in two cases with AVN. In contrast, only 2 of the 5 cases with a negative Hawkins sign developed AVN. According to Hawkins scoring system, 4 patients (25.0%) was in excellent, 7 patients (43.8%) in good, 4 patients (25.0%) in fair and 1 patient (6.3%) in poor. Conclusion: Incidence of AVN after operative treatment of fracture and dislocations of the talar neck was lower than that of previous reports. Hawkins sign had a high prognostic reliability, but absence of Hawkins' sign should not be considered a totally reliable indicator of development of avascular necrosis.

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