TREATMENT OF OPEN EXTRUDED FRACTURE NECK OF THE TALUS USING THE COMBINED METHOD OF EXTERNAL FIXATION MODIFIED FOR DYNAMIC ANKLE JOINT FIXATION AND KIRSCHNER WIRES
Bozovic Aleksandar,
Lalic Ivica,
Petrovic Dusan,
Jovanovic Sasa,
Elek Zlatan,
Sipka Aleksandar,
Bojovic Marko
Affiliations
Bozovic Aleksandar
1. University of Priština in Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia; 2. Clinical Hospital Center, Surgery Clinic, Kosovska Mitrovica, Serbia
Lalic Ivica
University Business Academy in Novi Sad, Faculty of Pharmacy, Novi Sad, Serbia
Petrovic Dusan
1. University of Priština in Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia; 2. Clinical Hospital Center, Surgery Clinic, Kosovska Mitrovica, Serbia
Jovanovic Sasa
Clinical Hospital Center, Surgery Clinic, Kosovska Mitrovica, Serbia
Elek Zlatan
1. University of Priština in Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia; 2. Clinical Hospital Center, Surgery Clinic, Kosovska Mitrovica, Serbia
Sipka Aleksandar
1. University of Novi Sad, Faculty of Medicine in Novi Sad, Novi Sad, Serbia; 2. Oncology Institute of Vojvodina, Sremska Kamenica – Novi Sad, Serbia
Bojovic Marko
1. University of Novi Sad, Faculty of Medicine in Novi Sad, Novi Sad, Serbia; 2. Oncology Institute of Vojvodina, Sremska Kamenica – Novi Sad, Serbia
Introduction: Open extruded fractures of the talus occur in 2% of talar fractures. These fractures are challenging for surgeons due to complications such as infection, nonunion, and arthritis. The most common treatment method is talus reimplantation and osteosynthesis. Case report: A 19-year-old presented with an open extruded fracture of the talus, classified as Hawkins II, following a fall from a height. Emergency surgery involved wound debridement, talus reimplantation, osteosynthesis with modified external fixation for dynamic ankle joint fixation (Mitkovic-type), and two Kirschner wires. Fragments were repositioned under C-Arm fluoroscopy. The patient received a 14-day antibiotic regimen (Cephalosporins, Aminoglycoside, Metronidazole) and thromboembolic prophylaxis for 35 days. After 6 weeks we allowed movements in the ankle joint with physical therapy. Gradual weight-bearing was allowed after 8 weeks. The osteosynthetic material was removed after 18 weeks, with full weight-bearing achieved after 6 months. Radiographic follow-up was conducted up to 24 months postoperatively, showing excellent healing with minimal dorsiflexion restriction. Conclusions: Treating this injury is a significant challenge. External fixation can be a viable method for managing open luxation fractures of the talus.
