Novel Treatment for a Completely Extruded Talus

Area of Science:

• Orthopedic Surgery
• Trauma Management
• Reconstructive Surgery

Background:

• Complete talar extrusion is a rare, high-energy injury with limited treatment options and variable outcomes.
• Tibiocalcaneal arthrodesis is a viable surgical option for restoring stability and reducing pain in affected limbs.
• Managing complications like wound dehiscence and infection is crucial for successful talar extrusion treatment.

Observation:

• A 52-year-old male sustained complete talar extrusion from a pedestrian-vehicle accident.
• The patient experienced wound dehiscence and recurrent ankle infections post-injury.
• Three years after the initial injury, the patient underwent tibiocalcaneal arthrodesis with a tantalum metal cone spacer and autologous bone grafting.

Findings:

• The surgical fusion healed successfully without nonunion, demonstrating the efficacy of the reconstructive technique.
• The patient achieved significant pain reduction and improved ankle stability post-surgery.
• The novel treatment facilitated independent ambulation without assistive devices.

Implications:

• This case represents the first report of using a metal spacer with autologous bone grafting for complete talar extrusion treated years after the initial injury.
• The findings suggest that this combined surgical approach can yield excellent outcomes in complex, delayed cases of talar extrusion.
• This innovative technique offers a promising solution for improving function and quality of life in patients with severe talar injuries.