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OP-Journal 2014; 30(2): 120-128
DOI: 10.1055/s-0034-1383178
Georg Thieme Verlag KG Stuttgart · New York

Talusfrakturen

Fractures of the Talus
Fabian Krause
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Publication History

Publication Date:
04 February 2015 (online)

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Zusammenfassung

Talusfrakturen sind seltene, aber in der Regel schwerwiegende Frakturen. Eine Einteilung erfolgt in Taluskopf-, Talushals- und Taluskorpusfrakturen, welche meist Folge von Hochenergietraumata sind. Davon unterschieden werden randständige Frakturen (z. B. Fraktur des Processus lateralis tali, „snowboarderʼs fracture“), die schon bei wenig Energie auftreten können. Talusfrakturen betreffen in der großen Mehrzahl wichtige Gelenkflächen und werden grundsätzlich operativ versorgt, es sei denn, sie sind absolut undisloziert. Die Besonderheit des Talus ist seine überwiegend aus Gelenkflächen bestehende Oberfläche und die damit verbundene generell prekäre Durchblutung bei Frakturen und Luxationen mit hoher Rate an Osteonekrosen und Pseudarthrosen.

Abstract

Fractures of the talus are rare but usually serious injuries. They are classified into fractures of the talar head, the talar neck, and the talar body; these fractures mostly arise from high-energy trauma. Apart from the high-energy fractures, low-energy peripheral talar fractures are also distinguished, i. e., fractures of the lateral process or “snowboarderʼs fractures”. In the majority of cases, fractures of the talus affect important articular surfaces and are treated operatively, unless they are absolutely undisplaced. A special feature of the talus is its surface that mainly consists of articular surfaces, and, coupled to this, its generally susceptible perfusion with a high rate of osteonecrosis and non-unions after fractures.

 

  • Literatur

  • 1 Wildenauer E. Die Blutversorgung der Talus. Z Anat 1950; 115: 32
    CrossrefPubMedGoogle Scholar
  • 2 Miller AN, Prasarn ML, Dyke JP et al. Quantitative assessment of the vascularity of the talus with gadolinium-enhanced magnetic resonance imaging. J Bone Joint Surg Am 2011; 93: 1116-1121
    CrossrefPubMedGoogle Scholar
  • 3 Kelly PJ, Sullivan CR. Blood supply of the talus. Clin Orthop Relat Res 1963; 30: 37-44
    PubMedGoogle Scholar
  • 4 Coltart WD. Aviatorʼs astragalus. J Bone Joint Surg Br 1952; 34: 545-566
    PubMedGoogle Scholar
  • 5 Dunn AR, Jacobs B, Campbell jr. RD. Fractures of the talus. J Trauma 1966; 6: 443-468
    CrossrefPubMedGoogle Scholar
  • 6 Hawkins LG. Fractures of the neck of the talus. J Bone Joint Surg Am 1970; 52: 991-1002
    CrossrefPubMedGoogle Scholar
  • 7 Sneppen O, Buhl O. Fracture of the talus. A study of its genesis and morphology based upon cases with associated ankle fracture. Acta Orthop Scand 1974; 45: 307-320
    CrossrefPubMedGoogle Scholar
  • 8 Canale ST, Kelly jr. FB. Fractures of the neck of the talus. Long-term evaluation of seventy-one cases. J Bone Joint Surg Am 1978; 60: 143-156
    CrossrefPubMedGoogle Scholar
  • 9 Inokuchi S, Ogawa K, Usami N. Classification of fractures of the talus: clear differentiation between neck and body fractures. Foot Ankle Int 1996; 17: 748-750
    CrossrefPubMedGoogle Scholar
  • 10 Tezval M, Dumont C, Stürmer KM. Prognostic reliability of the Hawkins sign in fractures of the talus. J Orthop Trauma 2007; 21: 538-543
    CrossrefPubMedGoogle Scholar
  • 11 McKeever F. Fractures of tarsal and metatarsal bones. Surg Gynecol Obstet 1950; 90: 735-745
    PubMedGoogle Scholar
  • 12 Comfort TH, Behrens F, Gaither DW et al. Long-term results of displaced talar neck fractures. Clin Orthop 1985; 199: 81-87
    PubMedGoogle Scholar
  • 13 Kundel K, Braun W, Scherer A. Spätergebnisse nach zentralen Talusfrakturen. Unfallchirurg 1995; 98: 124-129
    PubMedGoogle Scholar
  • 14 Lindvall E, Haidukewych G, DiPasquale T et al. Open reduction and stable fixation of isolated, displaced talar neck and body fractures. J Bone Joint Surg Am 2004; 86: 2229-2234
    CrossrefPubMedGoogle Scholar
  • 15 Pantazopoulos T, Galanos P, Vayanos E et al. Fractures of the neck of the talus. Acta Orthop Scand 1974; 45: 296-306
    CrossrefPubMedGoogle Scholar
  • 16 Grob D, Simpson LA, Weber BG et al. Operative treatment of displaced talus fractures. Clin Orthop Relat Res 1985; 199: 88-96
    PubMedGoogle Scholar
  • 17 Bellamy JL, Keeling JJ, Wenke J et al. Does a longer delay in fixation of talus fractures cause osteonecrosis?. J Surg Orthop Adv 2011; 20: 34-37
    PubMedGoogle Scholar
  • 18 Kenwright J, Taylor RG. Major injuries of the talus. J Bone Joint Surg Br 1970; 52: 36-48
    PubMedGoogle Scholar
  • 19 Frawley PA, Hart JA, Young DA. Treatment outcome of major fractures of the talus. Foot Ankle Int 1995; 16: 339-345
    CrossrefPubMedGoogle Scholar
  • 20 Boyd HB, Knight RA. Fractures of the astragalus. South Med J 1942; 35: 160-167
    CrossrefPubMedGoogle Scholar
  • 21 Brodén B. Roentgen examination of the subtaloid joint in fractures of the calcaneus. Acta Radiol 1949; 31: 85-88
    CrossrefPubMedGoogle Scholar
  • 22 Gustilo RB, Anderson JT. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses. J Bone Joint Surg Am 1976; 58: 453-458
    PubMedGoogle Scholar
  • 23 Marsh JL, Saltzman CL, Iverson M et al. Major open injuries of the talus. J Orthop Trauma 1995; 9: 371-376
    CrossrefPubMedGoogle Scholar
  • 24 Reckling FW. Early tibiocalcaneal fusion in the treatment of severe injuries of the talus. J Trauma 1972; 12: 390-396
    CrossrefPubMedGoogle Scholar
  • 25 Böhler L. The Treatment of Fractures. New York: Grune & Stratton; 1958
    Google Scholar
  • 26 Funk JR, Srinivasan SC, Crandall JR. Snowboarderʼs talus fractures experimentally produced by eversion and dorsiflexion. Am J Sports Med 2003; 31: 921-928
    PubMedGoogle Scholar
  • 27 Hawkins LG. Fracture of the lateral process of the talus. J Bone Joint Surg Am 1965; 47: 1170-1175
    PubMedGoogle Scholar
  • 28 Valderrabano V, Perren T, Ryf C et al. Snowboarderʼs talus fracture: treatment outcome of 20 cases after 3.5 years. Am J Sports Med 2005; 33: 871-880
    CrossrefPubMedGoogle Scholar
  • 29 Rammelt S, Grass R, Brenner P et al. Septic necrosis after third-degree open talus fracture in conjunction with complex trauma of the foot (floating talus). Trauma Berufskr 2001; 3 (Suppl. 02) S230-S235
    PubMedGoogle Scholar
  • 30 Schuind F, Andrianne Y, Burny F et al. Fractures et luxations de lʼastragale. Revue de 359 cas. Acta Orthop Belg 1983; 49: 652-689
    PubMedGoogle Scholar
  • 31 Rammelt S, Zwipp H, Gavlik JM. Avascular necrosis after minimally displaced talus fracture in a child. Foot Ankle Int 2000; 21: 1030-1036
    PubMedGoogle Scholar
  • 32 Peterson L, Goldie IF, Irstam L. Fracture of the neck of the talus. A clinical study. Acta Orthop Scand 1977; 48: 696-706
    CrossrefPubMedGoogle Scholar