Novel Treatment for a Completely Extruded Talus

Background: Complete talar extrusion is a rare injury that is typically caused by high-energy impact. Treatment for a completely extruded talus is limited and has variable outcomes and complications. Tibiocalcaneal arthrodesis is one of the best treatments for restoring stability and reducing pain in the affected limb. Case Report: A 52-year-old male had complete talar extrusion after a pedestrian vs vehicle accident, and his recovery was complicated by wound dehiscence and recurrent infections of the ankle. Three years after his original injury, the patient was treated with a tibiocalcaneal arthrodesis with tantalum metal cone spacer, autologous bone grafting with tibial reamer irrigator aspirator, and retrograde hindfoot nail. The fusion healed well without signs of nonunion. Following wound healing and recovery, the patient was able to ambulate without any assistive devices. Conclusion: To our knowledge, our case is the first report of the use of a metal spacer in conjunction with autologous bone grafting multiple years after an initial complete talar extrusion injury. The patient's novel treatment resulted in good postoperative outcomes, including significant improvement in pain, ankle stability, and independent ambulation.