Management of 6 Months old Neglected Talus Neck Fracture: A Case Report with Review of Literature

Neglected Talus Neck Fracture

  • Nagaraj Manju Moger Department of Orthopedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
  • Pragadeeshwaran J Department of Orthopedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India https://orcid.org/0000-0002-8177-650X
  • Mosharaf Hossain Sarkar Department of Orthopedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India https://orcid.org/0000-0002-0335-7713
  • Pradeep Kumar Meena Department of Orthopedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Keywords: Foot and Ankle, Fracture, Talus Fracture

Abstract

Talus fractures are very rarely seen and account for approximately 1 percent of fractures around the foot and ankle Talar neck fractures are likely to damage the anastomotic ring, resulting in disruption of blood supply to the talar body which leads to significant problems in fracture healing and integrity. Approximately 39 percent of midfoot and ankle fractures could be missed during initial evaluation due to a lack of adequate radiological and clinical examination. Among these missed injuries approximately 50 percent are talus fractures. A 23-year-old male patient came with complaints of pain over the left foot while walking for 6 months. He had a history of falls from 10 feet height 6 months back. He was conservatively managed in a local hospital without any proper diagnosis. He presented to us 6 months later with chronic, dull aching, continuous pain which aggravates while walking and standing. The diagnosis of the non-union fracture neck of talus was made after radiology and was managed by open reduction and internal fixation with cannulated cancellous screws along with ipsilateral iliac crest cancellous bone grafting. Lack of timely diagnosis escalates the vascular insult, delays timely intervention, and increases morbidity.

Downloads

Download data is not yet available.

References

Ahmad J, Raikin SM. Current Concepts Review: Talar Fractures. Foot Ankle Int. 2006;27(6):475–482. Available from: https://dx.doi.org/10.1177/107110070602700616.

Juliano PJ, Dabbah M, Harris TG. Talar neck fractures. Foot Ankle Clin. 2004;9(4):723–736. Available from: https://dx.doi.org/10.1016/j.fcl.2004.07.001.

Peterson L, Goldie IF. The Arterial Supply of the Talus: A Study on the Relationship to Experimental Talar Fractures. Acta Orthop Scand. 1975;46(6):1026–1034. Available from: https://dx.doi.org/10.3109/17453677508989293.

Dodd A, Lefaivre KA. Outcomes of Talar Neck Fractures. J Orthop Trauma. 2015;29(5):210–215. Available from: https://dx.doi.org/10.1097/bot.0000000000000297.

Elgafy H, Ebraheim NA, Tile M, Stephen D, Kase J. Fractures of the talus: experience of two level 1 trauma centers. Foot Ankle Int. 2000;21(12):1023–9. Available from: https://dx.doi.org/10.1177/107110070002101208.

Wedmore I, Young S, Franklin J. Emergency Department Evaluation and Management of Foot and Ankle Pain. Em Med Clin North Am. 2015;33(2):363–396. Available from: https://dx.doi.org/10.1016/j.emc.2014.12.008.

Khadabadi NA, Putti BB, Jatti RS, Kale DR. Management of 1 1 month old neglected talus neck fracture: A case report and review of literature. J Sci Soc. 2014;41(1):50–55. Available from: https://dx.doi.org/10.4103/0974-5009.126757.

Judd DB, Kim DH. Foot fractures frequently misdiagnosed as ankle sprains. Am Fam Physician. 2002;66(5):785–94.

Vallier HA, Nork SE, Barei DP, Benirschke SK, Sangeorzan BJ. Talar Neck Fractures: Results and Outcomes. J Bone Joint Surg Am. 2004;86(8):1616–1624. Available from: https://dx.doi.org/10.2106/00004623-200408000-00003.

Bastos LR, Ferreira RC, Mercadante MT. Analysis of Clinical and Functional Outcome and Complications of Talar Neck Fractures. Revista Brasileira de Ortopedia (English Edition). 2010;45:362–374. Available from: https://dx.doi.org/10.1016/s2255-4971(15)30382-7.

Pajenda G, Vécsei V, Reddy B, Heinz T. Treatment of talar neck fractures: Clinical results of 50 patients. J Foot Ankle Surg. 2000;39(6):365–375. Available from: https://dx.doi.org/10.1016/s1067-2516(00)80072-1.

Lindvall E, Haidukewych G, DiPasquale T, Herscovici D, Sanders R. Open Reduction and Stable Fixation of Isolated, Displaced Talar Neck and Body Fractures. J Bone Joint Surg. 2004;86(10):2229–2234. Available from: https://dx.doi.org/10.2106/00004623-200410000-00014. doi:10.2106/00004623-200410000-00014.

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

Published
2020-07-06
How to Cite
Moger, N. M., Pragadeeshwaran J, Sarkar, M. H., & Meena, P. K. (2020). Management of 6 Months old Neglected Talus Neck Fracture: A Case Report with Review of Literature. Asian Journal of Medical Research, 9(2), 11-13. https://doi.org/10.47009/ajmr.2020.9.2.OR3
Section
Orthopaedics