Defining Talar Head and Neck Pathology: The Malvern Classification System.

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Abstract

[Indexed for MEDLINE] 3. J Orthop Trauma. 2015 May;29(5):210-5. doi: 10.1097/BOT.0000000000000297. Outcomes of Talar Neck Fractures: A Systematic Review and Meta-analysis. Dodd A(1), Lefaivre KA. Author information: (1)Department of Orthopaedic Surgery, University of British Columbia, Vancouver, British Columbia, Canada. OBJECTIVES: To report the rates of osteonecrosis and subtalar arthritis after talar neck fractures and to examine if rates have changed over time. DATA SOURCES: A systematic review and meta-analysis of the English literature was performed using EMBASE, MEDLINE, CENTRAL, and Cochrane in November 2011 and updated in November 2014. STUDY SELECTION: Inclusion criteria were studies examining talar neck fractures that reported talar body osteonecrosis rates as a primary or secondary outcome. Exclusion criteria included case series with 50% pediatric patients, inability to isolate results of talar neck fractures, primary treatment of talar excision or arthrodesis, mean follow-up of 2 years of follow-up. CONCLUSIONS: The overall rate of osteonecrosis was 0.312. Rates for Hawkins' types I-IV were 0.098, 0.274, 0.534, and 0.480, respectively. The mean rate of subtalar arthritis was 0.49 but increased to 0.81 in studies with >2 years of follow-up. Complication rates are high in talar neck fractures, and patients should be counseled accordingly. DOI: 10.1097/BOT.0000000000000297