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Updated: Oct 10, 2025
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Autologous Microfractured and Purified Adipose Tissue for Arthroscopic Management of Osteochondral Lesions of the Talus
Published on: January 23, 2018
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[The complete dislocation of the talus or «missing talus».]
Z Szecel1, J P Berger1, G Lambeaux1
1) Service de Chirurgie orthopédique, CHC Mont-légia, Liège, Belgique.
Revue Medicale De Liege
|December 9, 2021
Summary
Complete talus dislocation, a rare high-energy injury, often involves open wounds and nearly always leads to avascular necrosis. Prompt surgical reimplantation is the recommended first-line treatment for this severe ankle injury.
Area of Science:
- Orthopedic Surgery
- Trauma Surgery
- Podiatric Medicine
Background:
- Complete talus dislocation, also known as 'missing talus', involves simultaneous dislocation of the tibiotalar, talocalcaneal, and talonavicular joints without talar fracture.
- This severe injury results from high-energy trauma, constituting 3-5% of all talus injuries.
Observation:
- The anterolateral dislocation is most common, with over 75% of cases being open injuries.
- Associated soft tissue damage frequently includes vascular lesions, leading to avascular necrosis of the talus in nearly all cases.
- Avascular necrosis is typically well-tolerated by patients.
Findings:
- Prompt surgical reimplantation of the talus following debridement is the recommended primary treatment.
- Talectomy combined with tibiocalcaneal arthrodesis is a viable secondary option if avascular necrosis is poorly tolerated.
- Isolated talectomy is contraindicated.
Implications:
- Early surgical intervention is crucial for managing complete talus dislocations and preventing long-term complications.
- Understanding the high incidence of avascular necrosis guides treatment strategies and patient expectations.
- This injury necessitates specialized orthopedic management to optimize outcomes and limb salvage.
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