Tobillo y pie

Resultados de las fracturas por estrés del talón. (I)

Markus J. Sormaala, MD*,,, Maria H. Niva, MD, PhD,, Martti J. Kiuru, MD, PhD, MSc, Ville M. Mattila, MD, PhD and Harri K. Pihlajamäki, MD, PhD From the Centre of Military Medicine, Helsinki, Finland, Department of Radiology, Helsinki University Central Hospital, Helsinki, Finland, and Orton Hospital, Helsinki, Finland

Background: Stress fractures of the talus are rare, and only a few small studies have been published. In the absence of follow-up studies, the outcomes of these injuries are unknown.

Hypothesis: Traumatic fractures of the talus frequently heal poorly, and stress fracture healing might remain inadequate. The purpose of this study was to determine the outcome of stress fractures of the talus treated in the authors’ institution with reduced exercise and nonweightbearing.

Study Design: Case series (prognosis); Level of evidence, 4.

Methods: Patients with a diagnosed stress fracture in the talus by magnetic resonance imaging between April 1997 and March 2005 were recalled for a follow-up inspection by an orthopaedic surgeon, magnetic resonance imaging, and plain radiographs to determine the outcome of the injury.

Results: One of the 9 patients in our sample declined the invitation, leaving 8 patients with 9 stress fractures in the talus who participated in the follow-up examination. Five patients displayed subchondral degeneration and edema near the original injury area in the follow-up magnetic resonance imaging. In 2 patients, the degeneration was also visible on the plain radiographs. Three patients had mild and 2 moderate symptoms after the mean follow-up time of 45 months (range, 12–74 months). No serious complications in the healing process were seen.

Conclusion: Stress fractures of the talus do not seem to seriously damage the foot. In a middle-term follow-up, however, minor to moderate symptoms and radiological degeneration of the injured area prevailed in roughly half of the patients.

The American Journal of Sports Medicine 34:1809-1814 (2006).

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