Reconstructive surgery after postraumatic infected talus necrosis.

OBJECTIVES

A case of a young female patient is presented who underwent a tibiocalcaneal arthodesis for infected necrosis of the talus after total talus extrusion. We report our surgical technique of tibiocalcaneal arthrodesis as a salvage procedure for this complex problem. It was performed in two stages. Total talectomy and implantation of antibiotic spacer was followed by tibiocalcaneal fusion using a blade plate. The bone loss was compensated with autodigested, antigen extracted allogeneic bone.

BACKGROUND

Total extrusion of the talus is a rare and severe injury of the foot. The outcome is unpredictable and the presence of infection and bone loss is a challenge for the surgeon to achieve a successful outcome.

METHODS

Union was defined both clinically and radiographically. The clinical outcomes were mesured using a AOFAS hindfoot score. The radiographic healing was determined by the presence of trabeculation across the arthrodesis.

RESULTS

The time of follow up was 18 months and the fusion was achieved after 8 months.

CONCLUSION

The presented technique for tibiocalcaneal arthrodesis is an option for the treatment of these serious lower extremity injuries and chemosterilized, antigen-extracted autolyzed allograft is appropriate for the reconstructive procedures of the foot and ankle (Fig. 2, Ref. 6).