Background

Epidemiological data on talus fractures from large nationwide and multicenter studies are rare. This study aims to describe the epidemiology, fracture classification and treatment regimens of talus fractures in a large adult Swedish population.

Methods

This observational study is based on data from the Swedish Fracture Register (SFR) including talar fractures in patients ≥18 with a sustained fracture between 2012 and 2021. Epidemiological data on sex, age, injury date, injury mechanism and type (high or low energy trauma), fracture classification (side, type), initial treatment and mortality were analysed.

Results

We included 1794 talus fractures (1757 patients, 60 % men). Mean age was 40.3 years (range 18–96), and a biphasic age distribution was seen in women. High-energy trauma caused 33 % of all talus fractures. Of all talus fractures, 817 (45.5 %) were classified as AO/OTA type A fractures (avulsion), 370 (20.6 %) as type B (neck) and 435 (24.2 %) as type C (body). The remaining 172 (9.6 %) talus fractures were not classified/unclassifiable. Men were in the majority in all fracture groups except A1. For type A1–3, B1 and C1–2 fractures, most patients were treated non-operatively; in B2–3 and C3 fractures most patients received operative management. Fracture fixation with screws was the dominating surgical treatment. The overall 30-day mortality was 0.2 %.

Conclusion

Talus fractures are most commonly encountered in young and middle-aged men. In contrast to men, a biphasic age distribution was observed in women. Approximately half of the talus fractures are avulsions. Operative treatment, mostly screw fixation, is performed in more complex fracture configurations (B2, B3 and C3 fractures).

Level of evidence

IV, retrospective observational cohort study

中文翻译：

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距骨骨折的流行病学、分类、治疗和死亡率：对瑞典骨折登记处 1794 例距骨骨折的观察性研究

背景

来自全国范围内和多中心研究的关于距骨骨折的流行病学数据很少。本研究旨在描述大量瑞典成年人群中距骨骨折的流行病学、骨折分类和治疗方案。

方法

这项观察性研究基于瑞典骨折登记处 (SFR) 的数据，包括 2012 年至 2021 年间 ≥18 岁且持续性骨折患者的距骨骨折。关于性别、年龄、受伤日期、受伤机制和类型（高能量或低能量）的流行病学数据外伤）、骨折分类（侧、类型）、初始治疗和死亡率进行了分析。

结果

我们纳入了 1794 例距骨骨折（1757 例患者，60% 为男性）。平均年龄为 40.3 岁（范围 18-96 岁），女性呈双相年龄分布。高能量创伤占所有距骨骨折的 33%。在所有距骨骨折中，817 例 (45.5%) 被分类为 AO/OTA A 型骨折（撕脱），370 例 (20.6%) 被分类为 B 型（颈部），435 例（24.2%）被分类为 C 型（身体）。其余 172 例 (9.6 %) 距骨骨折未分类/无法分类。除 A1 外，所有骨折组均以男性为主。对于 A1-3、B1 和 C1-2 型骨折，大多数患者采用非手术治疗；在 B2-3 和 C3 骨折中，大多数患者接受了手术治疗。用螺钉固定骨折是主要的手术治疗。总体 30 天死亡率为 0.2%。

结论

距骨骨折最常见于青年和中年男性。与男性相反，在女性中观察到双相年龄分布。大约一半的距骨骨折是撕脱。手术治疗，主要是螺钉固定，用于更复杂的骨折结构（B2、B3 和 C3 骨折）。

证据等级

四、回顾性观察队列研究