FRACTURES OF THE TALUS – DIFFERENCES BETWEEN CHILDREN AND ADOLESCENTS

Abstract

Background: Fractures of the talus represent serious injuries of the foot skeleton. The most significant complications include osteonecrosis and posttraumatic mal-alignment with subsequent arthritis. The aim of our study was to compare treatment and outcome of fractures of the talus between children and adolescents.

Methods: From 1990 to 2005 24 patients (18 male, 6 female) presented with 25 fractures of the talus. The medical records were reviewed retrospectively. At follow-up the functional outcome was measured using the Foot-Function-Index.

Results: 9 patients were 12 years of age or younger, 15 patients presenting 16 talar fractures were older than 12 years. While the majority of fractures of the talus in children younger than 12 years of age were classified as Marti-Weber Type I and II fractures, more than two thirds of the fractures in patients older than 12 years were Marti-Weber Type III and IV fractures. Two thirds of the patients younger than 12 years were treated non-operatively while non-operative treatment was possible in only 3 talar fractures in adolescents. No necrosis at follow-up (mean period: 3.2 years, range 7 months to 8.4 years following end of treatment) was detected in children (< 12 a), while 5 patients older than 12 years developed persisting necrosis.

Conclusion: Even tough there is no apparent difference in the cause of the trauma leading to fractures of the talus adolescents present with more severe fractures of the talus compared to children younger than 12 years of age. Additionally we did not observe persistent osteonecrosis in patients less than 12 years old and the outcome is favorable in the majority of the cases irrespective of the mode of treatment.