2 A Retrospective Analysis of the Definitive Management of Open Talus Fractures at a Major Trauma Centre and an Audit of BOAST 4 Guidelines

Abstract Currently, the management of open talus fractures is based upon BOAST 4 guidelines although there no suggested definitive management, thus surgeon preference. This retrospective analysis aims to clarify debate between ORIF and tibiocalcaneal fusion (FUSION). A review from 2014–2021 returned foureen patients with fifteen fractures. Seven cases were initially managed ORIF, five definitively FUSION. We collected patient's age, gender, surgical complications, risk factors post-treatment functional ability pain compliance guidelines. Comparison FUSION groups showed statistically significant difference in EQ-5D-5L score (P = 0.13), FAAM-ADL 0.20), FAAM-Sport 0.34), infection rate 0.55), times 0.91) time weight bearing 0.39), despite a higher proportion polytrauma Hawkins III IV group. typically used as second line or failed ORIF. However, are lack studies that directly compared outcome fracture Our results demonstrate for first time, may not be inferior terms patient outcome, rate, quality-of-life, patients. Of note, have increased risks complications such osteonecrosis non-union, should considered viable option mitigate these potential