Surgical management of traumatic talus defects: A comprehensive review

The talus is a critical bone in the foot, located between the tibia and calcaneus, playing a key role in weight-bearing and force transmission. It forms a stable structure with the tibia and fibula via the ankle joint and helps maintain foot flexibility with the calcaneus and navicular through the subtalar joint. Due to its cartilage-covered surface and lack of direct muscle attachment, its blood supply mainly depends on surrounding soft tissue. As a result, traumatic injuries can disrupt blood flow, leading to ischemic bone necrosis and significant impairment of foot function. Traumatic talus defects are typically caused by high-energy trauma, such as car accidents or sports injuries, and often involve talar dislocation, comminuted fractures, or open wounds. These injuries can also damage soft tissues and increase the risk of infection. Symptoms include pain, deformity, ankle instability, and loss of weight-bearing ability. Given the complexity of talus defects and the challenges of treatment, no universal guideline exists. Surgical treatment faces difficulties in reconstructing bone structure, restoring blood supply, controlling infection, and ensuring long-term functional recovery. Recent advancements in surgical treatment for traumatic talus defects include talus reimplantation, ankle arthrodesis, Ilizarov technique, Masquelet technique, and 3D Printing Prosthesis Technology. This article reviews the latest progress, compares the advantages and disadvantages of different techniques, and discusses their indications. It also highlights limitations and future developments to provide clinical insights and guide future research.