Rectus abdominis muscle graft post-talectomy: a new approach

This case represents an option a surgeon has when confronted with an extraordinary dilemma. A 43-year-old male presented to the emergency room with a septic ankle joint along with a fracture through the body of the talus. The surgeons incised and drained the ankle joint and performed a talectomy after finding intraoperatively that the soft, fractured, deformed talus was severely osteomyelitic. After weeks of intravenous antibiotics, a more definitive procedure was needed. After consulting different specialties for their opinion, a procedure was decided upon. The rectus abdominis muscle was hosted with its vascular supply intact and relocated into the ankle joint. The artery to this muscle was anastamosed to the anterior tibial artery. This, acts as both a spacer and a joint between the calcaneus and the tibia. After a few operations and months of physical therapy, this patient walks without a limp, free of pain or any gait-supporting device. There has not been any mention of this type of procedure in any of the literature to date.