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Published on: November 8, 2024
[Arthroscopic-assisted closed reduction and internal fixation with absorbable screws for Hawkins type Ⅱ talar neck
Zhihuan Dong1, Zhenhao Cao2, Haiquan Dong1
1School of Clinical Medicine, Shandong Second Medical University, Weifang Shandong, 261000, P. R. China.
Objective:
To explore the effectiveness of arthroscopic-assisted closed reduction and internal fixation with absorbable screws in the treatment of Hawkins type Ⅱ talar neck fractures.
Methods:
A retrospective analysis was conducted on the clinical data of 31 patients with closed Hawkins type Ⅱ talar neck fractures between October 2021 and July 2023, all of whom were treated with arthroscopic-assisted closed reduction and internal fixation with absorbable screws. There were 18 males and 13 females with an average age of 35.9 years (range, 17-61 years). Causes of injury included sports injuries in 26 cases and impact injuries in 5 cases. The time from fracture to operation was 3-5 days (mean, 3.7 days). During follow-up, ankle pain and function were assessed using the visual analogue scale (VAS) score and the American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Score (AOFAS-AHS), while radiological examinations were used to evaluate the quality of fracture reduction and healing.
Results:
All operations were successfully completed, and all incisions healed by first intention. All patients were followed up 12-16 months (mean, 13.0 months). One patient experienced persistent pain, limping, and joint dysfunction postoperatively, which returned to normal after symptomatic treatment. At 3 months after operation and last follow-up, the VAS scores were 2.7±0.9 and 1.3±0.8, respectively; the AOFAS-AHS were 74.5±4.7 and 90.9±3.6, respectively. There were significant differences in VAS score and AOFAS-AHS between different time points ( P<0.05). At last follow-up, all fractures healed, and the internal fixation was secure. No complication such as talar necrosis, subtalar joint stiffness, wound infection, or screw irritation occurred during follow-up.
Conclusion:
Arthroscopic-assisted closed reduction and internal fixation with absorbable screws for Hawkins type Ⅱ talar neck fractures has the advantages of minimal trauma, precise screw placement, few complications, and avoiding secondary screw removal, with satisfactory effectiveness.
