Infection Rates and Surgical Procedures Associated With Isolated Open Talar Neck and Body Fractures

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Infectious Disease

Background:

• Open fractures of the talar body and neck are rare injuries.
• Existing literature shows wide variations in deep infection rates and subsequent surgical needs.
• This study aims to clarify infection incidence and surgical outcomes for isolated open talus fractures.

Purpose of the Study:

• To determine the incidence of deep infections in isolated open talar body and neck fractures.
• To assess the total number of surgeries performed (TSP), secondary salvage procedures (SSPs), and nonsalvage procedures (NSPs).

Main Methods:

• A retrospective case-control study was conducted.
• 32 consecutive patients with isolated open talus fractures (22 neck, 10 body) were analyzed.
• Average follow-up duration was 39.2 months.

Main Results:

• Deep infection occurred in 15.6% of fractures, with 50% of body fractures infected versus 0% of neck fractures (P < .001).
• Infected fractures required an average of 5.8 TSPs and 100% required SSPs, compared to 2.1 TSPs and 29.6% SSPs in uninfected fractures.
• Single extensile surgical approaches were more common in the infected group (P = .04).

Conclusions:

• The incidence of deep infection after isolated open talus fractures is notably high, particularly in body fractures.
• Infected talus fractures necessitate a significantly higher number of surgical interventions, including salvage procedures.
• Early identification and management strategies are crucial for improving outcomes in these complex injuries.