Reconstructive surgery after postraumatic infected talus necrosis

A case of a young female patient is presented who underwent a tibiocalcaneal arthodesis for infected necrosis of the talus after total talus extrusion. We report our surgical technique of tibiocalcaneal arthrodesis as a salvage procedure for this complex problem. It was performed in two stages. Total talectomy and implantation of antibiotic spacer was followed by tibiocalcaneal fusion using a blade plate. The bone loss was compensated with autodigested, antigen extracted allogeneic bone.

Total extrusion of the talus is a rare and severe injury of the foot. The outcome is unpredictable and the presence of infection and bone loss is a challenge for the surgeon to achieve a successful outcome.

Union was defined both clinically and radiographically. The clinical outcomes were mesured using a AOFAS hindfoot score. The radiographic healing was determined by the presence of trabeculation across the arthrodesis.

The time of follow up was 18 months and the fusion was achieved after 8 months.

The presented technique for tibiocalcaneal arthrodesis is an option for the treatment of these serious lower extremity injuries and chemosterilized, antigen-extracted autolyzed allograft is appropriate for the reconstructive procedures of the foot and ankle (Fig. 2, Ref. 6).