Journal of Foot and Ankle Surgery
Volume 49, Issue 2 , Pages 172-175, March 2010

Reimplantation of a Totally Extruded Talus: A Case Report

  • Hichem Mnif, MD

      Affiliations

    • Orthopaedic Surgeon, Department of Orthopaedic Surgery, Monastir, Tunisia
    • Corresponding Author InformationAddress correspondence to Hichem Mnif, Department of Orthopaedics, Monastir, Tunisia.
    • ,
  • Makram Zrig, MD

      Affiliations

    • Orthopaedic Surgeon, Department of Orthopaedic Surgery, Monastir, Tunisia
    • ,
  • Mustapha Koubaa

      Affiliations

    • Professor of Orthopaedic Surgery, Department of Orthopaedic Surgery, Monastir, Tunisia
    • ,
  • Rafik Jawahdou, MD

      Affiliations

    • Resident in Orthopaedic Surgery, Department of Orthopaedic Surgery, Monastir, Tunisia
    • ,
  • Imed Hammouda, MD

      Affiliations

    • Resident in Orthopaedic Surgery, Department of Orthopaedic Surgery, Monastir, Tunisia
    • ,
  • Abderrazek Abid

      Affiliations

    • Professor of Orthopaedic Surgery, Department of Orthopaedic Surgery, Monastir, Tunisia

published online 16 December 2009.

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.

Level of Clinical Evidence: 4

Keywords: ankle, arthrosis, avascular necrosis, foot, infection, injury, osteomyelitis

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 Financial Support: None reported.

 Conflict of Interest: None reported.

PII: S1067-2516(09)00407-4

doi:10.1053/j.jfas.2009.09.003

Journal of Foot and Ankle Surgery
Volume 49, Issue 2 , Pages 172-175, March 2010

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