OUTCOMES OF MANAGEMENT IN TALAR FRACTURES IN BHUBANESWAR, ODISHA: A RANDOMIZED PROSPECTIVE THERAPEUTIC STUDY

INTRODUCTION: Talar fractures are difficult and rare injuries with incidence of less than 2%1, are one of the most challenging and devastating injuries with varied prognosis, posing a real time challenge to orthopedic surgeons. METHODS: The study is a prospective multicenter randomized therapeutic study initiated in December '2006 on 40 patients with talus fracture to highlight and compare the different modalities of management of talar fractures in terms of functional and clinical results and complications. RESULTS: Out of 40 patients, 32 were male and 8 were female with a male/female ratio of 4:1. Most fractures were due to RTA in 22 cases. Most fractures were in neck of talus in 20 (50%). Out of 40 talar fractures, 10 were managed conservatively, 18 operated with screw fixation, 4 were fixed with cross K-wires and 8 old cases were managed with Blair's fusion. We experienced complications in 12 cases. DISCUSSION: A high degree of suspicion is required for the diagnosis of talus/ talar processes fractures, talus being the second most common tarsal bone to fracture. The preferred surgical timing for talar neck fractures is controversial. But the scenario in the sub-continent is quite different wherein the patients report late to the hospital often due to ignorance, quack therapy and illiteracy, often presenting with complicated and neglected injuries. Also, published literature and long term prospective studies on talar fractures, its treatment and complications based on our population is lacking.