Completely extruded talus without soft tissue attachments

Area of Science:

• Orthopedic surgery
• Traumatology
• Bone reconstruction

Background:

• Completely extruded talus fractures are exceptionally rare injuries.
• Management typically involves complex reconstructive procedures or amputation.

Observation:

• A 45-year-old male sustained a complete talus extrusion from a rock-climbing fall.
• The extruded talus was preserved in a bone bank.
• Initial treatment included extensive wound debridement and irrigation.

Findings:

• A primary subtalar fusion was attempted but failed due to aseptic loosening and osteolysis.
• A subsequent tibiocalcaneal ankle fusion with a femoral head allograft successfully reconstructed the defect.
• At 24 months, the patient demonstrated functional midfoot motion and tibio-talar-calcaneal fusion.

Implications:

• This case highlights a successful salvage strategy for a completely extruded talus.
• Tibiocalcaneal fusion with allograft provides a viable option for severe talar defects.
• The patient regained significant functional capacity and activity levels post-reconstruction.