Joint‐Preserving Surgery for Talar Malunions or Nonuions

• DOI: 10.1111/os.12301
• Publication Date: 2017-03-30T22:57:41Z
• Authors: Gang Chen; Mu Hu; Yang Xu; Yue‐huan Zhen; Yuan Hong; Xiang‐yang Xu
• Keywords: Malunion; Pseudarthrosis; Avascular Necrosis

To describe the technique and analyze outcomes of joint-preserving surgical treatments which included anatomical reconstruction or alignment correction for talar malunions nonunions, avoid development degenerative changes in adjacent joints.Eight patients who had painful nonunions treated between 2009 2015 were this retrospective study. The mean age was 35.6 years, with aged from 18 to 58 years. Two neck fractures six body fractures. According a classification post-traumatic deformities, five classified as type I (malunion and/or residual joint displacement), two II (nonunion one III partial avascular necrosis [AVN]). Of these patients, cases an osteotomy through malunited fracture removal pseudarthrosis, corrected by supramalleolar calcaneal osteotomies owing complete disappearance former lines. follow-up evaluation methods 36-Item Short Form Health Survey (SF-36) score, American Orthopaedic Foot Ankle Society (AOFAS) range motion (ROM), radiological analysis. differences postoperative scores preoperative evaluated statistically paired Student's t-test. Significance assumed at P < 0.05.The time 25.6 months. No wound healing problems infections observed. Solid union obtained without redislocation all cases, no signs progression AVN. At months (range, 16-36 months) after reconstruction, satisfied result. AOFAS score increased 30.0 ± 7.0 pre-operatively 86.5 7.8 post-operatively (P 0.001), SF-36 38.8 4.1 81.4 7.7 average ROM (tibiotalar joint) 40.5° 8.7° 43.9° 7.2° 0.05).Joint-preserving procedures can bring about satisfactory outcomes, appropriate procedure should be adopted according different types deformities.