Reimplantation of a Totally Extruded Talus: A Case Report

• Published in: The Journal of foot and ankle surgery Vol. 49; no. 2; pp. 172 - 175
• Main Authors: Mnif, Hichem, MD, Zrig, Makram, MD, Koubaa, Mustapha, Jawahdou, Rafik, MD, Hammouda, Imed, MD, Abid, Abderrazek
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2010; Elsevier
• Subjects: Adult; ankle; Ankle Injuries - surgery; arthrosis; avascular necrosis; Bacterial arthritis and osteitis; Bacterial diseases; Biological and medical sciences; Diseases of the osteoarticular system; External Fixators; foot; Fractures, Open - surgery; Human bacterial diseases; Humans; infection; Infectious diseases; injury; Joint Dislocations - surgery; Male; Medical sciences; Miscellaneous. Osteoarticular involvement in other diseases; Orthopedics; Osteoarthritis; osteomyelitis; Replantation - methods; Talus - injuries; Talus - surgery; osteomyelitis; arthrosis; infection; 4; injury; avascular necrosis; ankle; foot; Human; Heel; Diseases of the osteoarticular system; Astragalus; Necrosis; Foot; Ankle; Case study; Infection; Ankle joint; Treatment; Surgery; Orthopedics; Osteitis; Arthropathy; Degenerative disease; Osteoarthritis; Replantation
• ISSN: 1067-2516; 1542-2224
• DOI: 10.1053/j.jfas.2009.09.003

Abstract Total extrusion of the talus is an unusual injury, and the obvious risks of reimplantation of the extruded bone include infection and avascular necrosis. In this article, the authors present the case of a 34-year-old man who sustained an open ankle injury with complete extrusion of the talus. The talus was recovered at the scene of the accident, and subsequently reimplanted along with ankle stabilization with pins and an external fixator. At 6 weeks following the osseous surgery, final soft tissue reconstruction with a suralis flap was performed. At 3 years after the injury, radiographs revealed spontaneous fusion of the tibiotalar and subtalar joints, and the clinical examination and history indicated satisfactory weight-bearing function of the involved foot and ankle. The definitive treatment of this serious lower extremity injury remains controversial, and the use of large allogeneic bone grafts, vascularized bone grafts, and tibiocalcaneal fusion, as well as reimplantation of the extruded talus have been recommended.