Influence of Surgical Approach and Fixation on Complications in Talus Fractures: A Multicenter Review

Fractures of the talus are infrequent injuries often associated with substantial morbidity and imperfect outcomes. We undertook a retrospective review of talus fractures at multiple level 1 trauma centers in order to identify common treatment patterns and potential predictors of complications. All cases of talar fractures meeting inclusion criteria at our institution were reviewed. 54 of 103 talus fractures met inclusion criteria. 33 (61.1%) involved the talar neck, 13 (24.1%) the talar body, and 6 (9.2%) involved the lateral process. The most common etiology was motor vehicle accidents, accounting for 27 (50.0%). Mean follow up was 13.6 months (range 8-52 months). 37 (68.5%) fractures were fixated with screws, and 17 (31.5%) were fixated with a plate construct. Single and dual incisions were used in 63.0% and 25.9% of cases, respectively. Complications were seen in 46.3% of cases, with post-traumatic osteoarthritis being the most common complication (35.1%). Avascular necrosis occurred in 4 (7.4%) patients. No independent variables met the statistical threshold to be associated with complications. The present data alludes to possibility of over-reporting complications due to historical literature and the need for further studies.