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Ankle Joint

Ankle Joint

The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...

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A Teleoperated Robotic System-Assisted Percutaneous Transiliac-Transsacral Screw Fixation Technique

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Temporary Transarticular Screw Fixation for Traumatic Peritalar Instability After Talar Fracture-Dislocation.

Serge Andreou¹, Najeeb Baig¹, Rumyah Rafique¹

¹Detroit Medical Center/Wayne State University Orthopaedic Surgery, USA.

Foot & Ankle Orthopaedics

|February 16, 2026

Summary

Temporary transarticular screw fixation effectively resolved traumatic peritalar instability after talar fracture-dislocation. This minimally invasive technique offers a valuable adjunct for complex talar trauma management, with a lower avascular necrosis rate than some published series.

Keywords:

avascular necrosis peritalar instability subtalar joint talus fractures transarticular fixation trauma

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Published on: November 8, 2024

Area of Science:

Orthopedic Surgery
Trauma Surgery
Foot and Ankle Surgery

Background:

Traumatic peritalar instability following talar fracture-dislocation presents a significant surgical challenge.
Current stabilization methods often involve extensive soft tissue dissection or external fixation.
There is no established consensus on adjunctive stabilization techniques.

Purpose of the Study:

To evaluate the efficacy and safety of temporary transarticular screw fixation as an adjunct to open reduction and internal fixation (ORIF) for traumatic peritalar instability.
To assess outcomes including resolution of instability, complications, and functional recovery.

Main Methods:

Retrospective case series of 9 patients (10 extremities) treated between 2015 and 2024.
Persistent subtalar instability after talar ORIF was addressed with temporary transarticular screw fixation across the subtalar joint.
Screws were removed post-fracture union; outcomes included instability resolution, avascular necrosis (AVN), posttraumatic arthritis (PTA), and infection.

Main Results:

All 10 extremities achieved full resolution of peritalar instability.
Two extremities developed AVN (20%), and 3 required subsequent arthrodesis.
Nine extremities showed some form of PTA; 8 of 9 patients returned to full activity.
Three infections occurred, with 1 deep infection requiring arthrodesis.

Conclusions:

Temporary transarticular screw fixation is a potentially safe and effective adjunct for managing traumatic peritalar instability.
The technique demonstrated a lower AVN rate compared to some published data, though caution is advised due to sample size.
High PTA rates are consistent with injury severity; this minimally invasive approach may benefit complex talar trauma cases.