Patient-Reported Outcomes After Lateral Process Talus Fracture. Issue 12 (December 2021)

• Record Type: Journal Article
• Authors: Ross, Hunter; Marchand, Lucas; Cardon, Jeffery; Beals, Timothy; Barg, Alex; Nickisch, Florian; Haller, Justin M.
• Is Part Of: Journal of orthopaedic trauma. Volume 35:Issue 12(2021)
• Publication Date: 2021-12
• Subjects: talus -- lateral process -- lateral process fracture -- subtalar arthritis -- patient-reported outcomes; Orthopedics -- Periodicals; Wounds and injuries -- Periodicals; Orthopedics -- Periodicals; Wounds and Injuries -- therapy -- Periodicals; Periodicals; 617.47044
• DOI: 10.1097/BOT.0000000000002099
• Languages: English
• ISSNs: 0890-5339

Abstract

Abstract : Objectives: To evaluate functional outcome after lateral process talus fracture using patient-reported instruments and identify injury characteristics that portend a worse prognosis. Design: Retrospective case series. Setting: Level 1 academic trauma center. Patients/Participants: Fifty-three patients with isolated lateral process talus fracture and 12 months of minimum follow-up. Main Outcome Measurements: Patient-Reported Outcomes Measurement Information System (PROMIS) physical function (PF) and Foot and Ankle Ability Measure (FAAM). Results: Mean patient age was 33 years (range, 17–62 years), and mean follow-up was 6.5 years (range, 1–12 years). Twenty-one patients were initially treated nonoperatively and 14 of these patients (67%) failed nonoperative management. Patients who failed nonoperative treatment more commonly had a displaced fracture (12 patients) ( P = 0.009). Thirty-two patients had displaced fracture and were treated with early operative fixation. For the entire cohort, final PROMIS PF was 55 (SD −8.3), FAAM Activities of Daily Living (ADL) was 89 (SD −14), and FAAM sport was 77 (SD −20). The patients treated with operative fixation had significantly larger fracture fragments (2050 vs. 1066 mm 3, P = 0.017). There was no difference in final outcome between operative and nonoperative patients for PROMIS PF ( P = 0.84), FAAM ADL ( P = 0.95), or FAAM sport ( P = 0.94). There were significantly more subtalar fusions in the nonoperative group (4 patients) as compared to the operative group (one patient) ( P = 0.05). Conclusions: Most patients with lateral process talus fracture achieve excellent outcome as measured by the PROMIS PF and FAAM at medium-term follow-up. Displaced fractures are likely best managed with early surgical treatment. Patients treated with early surgery have significantly fewer subtalar fusions as compared to patients with nonoperative treatment. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.