Background: Talar fractures are frequently associated with long-term complications. By major fracture displacement, the results are generally poor with a high incidence of avascular necrosis, osteoarthritis and malunion. In this study we investigated the incidence of long-term complications and the need for secondary surgery following screw-, wire and/or plate fixation of talar fractures operated at Oslo University Hospital (OUH), Ullevaal during a period of ten years.
Methods: Fifty-one patients with 53 talar fractures were included in the study. Information regarding the accident, the treatment and the post fracture period were obtained from the patients’ medical records. Initial radiographs were evaluated. The patients completed two questionnaires; one about life quality and one about the post fracture period. At a follow-up clinical visit, the ankle function, plain radiographs and computerized tomography were evaluated.
Results: Osteoarthritis was seen in 98%, avascular necrosis in 65% and malunion in 2% of the fractures. Mean EuroQol-5d (Eq5d) index score was 0.61±0.25 (mean±SD), mean visual analogue scale (VAS) score was 68±18 (mean±SD) and mean American Orthopaedic Foot and Ankle Society (AOFAS) score was 73±17 (mean±SD). Secondary surgery was needed in 38% of the fractures. After the clinical follow-up visit, additionally 26% were scheduled for secondary surgery. VAS and AOFAS ankle-hindfoot score were low in these patients.
Conclusion: Talar fractures are associated with high rates of long-term complications. Pain/discomfort, limitations in walking and daily activities are the main complaints. Osteoarthritis and avascular necrosis are frequent. Many patients need secondary surgery due to poor ankle function.