Reconstructive surgery after postraumatic infected talus necrosis

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Reconstruction
• Trauma Management

Background:

• Total talus extrusion is a rare, severe foot injury with unpredictable outcomes.
• Infection and significant bone loss present major challenges in treating talus extrusion.
• Salvage procedures are critical for managing complex foot and ankle trauma.

Observation:

• A two-stage tibiocalcaneal arthrodesis was performed for infected talus necrosis post-extrusion.
• The first stage involved total talectomy and antibiotic spacer implantation.
• The second stage utilized a blade plate for tibiocalcaneal fusion, with bone loss addressed by allogeneic bone graft.

Findings:

• Successful tibiocalcaneal fusion was achieved in 8 months, with an 18-month follow-up period.
• Clinical outcomes were assessed using the AOFAS hindfoot score.
• Radiographic evidence confirmed bony trabeculation across the arthrodesis site.

Implications:

• This two-stage tibiocalcaneal arthrodesis technique serves as a valuable option for complex lower extremity injuries.
• Chemosterilized, antigen-extracted autolyzed allograft is suitable for foot and ankle reconstructive procedures.
• The presented surgical approach offers a potential solution for limb salvage in severe foot trauma.