Can we improve long-term prognoses for patients with talar neck fractures?

A person with a broken ankle in a plaster cast rests on a couch with crutches in the background

A talar neck fracture is a break in one of the bones that forms the ankle. They often occur during a high-energy event, such as a car accident and, though relatively uncommon, are potentially devastating with significant long term morbidity.

Data access has been approved for a retrospective study of all adults who sustained a talar neck fracture and underwent surgery between 1985 and 2011 in British Columbia in order to better inform patients who sustain talar neck fractures about their prognosis.

The study is being undertaken by graduate student, Mark Xu, a Clinical Fellow at Vancouver General Hospital, under the supervision of Kelly Lefaivre, Associate Professor at the University of British Columbia and Orthopedic Surgeon at Vancouver General Hospital.

“Unfortunately, there is a lack of studies in the literature looking at long-term outcomes following talar neck fractures,” according to Mr Xu. “Current reports are limited in their scope, often reporting only short to medium term follow-up with small patient numbers. When counselling a patient following these types of complex injuries, one cannot reliably inform the patient what their risk of requiring further surgery is, without the kinds of investigative studies we are proposing. This will provide novel evidence for physicians providing care for patients with talar neck fractures, and update the existing literature.”

The primary aim of the research is to identify patients by index event, then use their unique patient identification number to follow them forward and determine rates of further operations affecting the talus at any hospital within British Columbia, with a minimum 10 year follow up.

The research also aims to determine whether the risk factors for re-operation are related to demographic data, comorbidities at the time of the initial surgery, smoking status, open injuries, and time to surgical fixation. Changes over time of type and number of re-operations following the fracture will also be investigated.

PopData will link five data sets from the BC Ministry of Health for the project, which is funded by AO Trauma North America.