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Total extrusion of the talus: a case report
Carlo Montoli1, Marco De Pietri, Sara Barbieri
1Orthopaedic and Traumatology Department, Ospedale di Circolo, Mario Boni Medicine School, University of Insubria, Varese, Italy. cicciotec@hotmail.com <cicciotec@hotmail.com>
Summary
Total talus extrusion without bone recovery is rare. This case study shows retrograde tibiocalcaneal nailing successfully treated a complex talus enucleation injury, bypassing bone defects.
Area of Science:
- Orthopedic Surgery
- Trauma Surgery
- Podiatric Medicine
Background:
- Total talus extrusion is an exceptionally rare and severe injury.
- Management of such injuries is challenging due to bone loss and high complication rates.
Observation:
- A 25-year-old male sustained open total talus enucleation in a motorcycle accident, with the talus unrecovered.
- The patient developed a polymicrobial infection and later osteomyelitis requiring surgical intervention.
Findings:
- Initial tibiocalcaneal stabilization with an external fixator was performed.
- Surgical management included debridement, sequestrectomy, antibiotic-impregnated beads, tibiocalcaneal arthrodesis, and a revision with retrograde tibiocalcaneal nailing.
- Retrograde nailing provided stability and clinical success despite significant bone defects.
Implications:
- Retrograde tibiocalcaneal nailing can be an effective salvage option for total talus enucleation when the talus is unrecoverable.
- This technique bypasses bone defects, offering stability and potentially avoiding more extensive reconstructions.
- Further research is needed to establish definitive treatment protocols for this rare injury.