Talar Malunion and Non-Union

Talar malunions can cause significant morbidity in the form of hindfoot deformity, pain, and gait abnormalities. Malunion and nonunion may coexist, making treatment more challenging. Reconstruction is feasible in cases where the talar dome cartilage is intact, avascular necrosis is minimal or partial, and no infection. The addition of subtalar fusion during talus reconstruction can improve revascularization and healing without causing significant disability. In cases where the bone has significantly deformed over time, a triple fusion may be a better option to correct the hindfoot deformity while leaving the talus malunited.