Early Reimplantation for Open Total Talar Extrusion

Abstract

Early reimplantation is recommended for open total talar extrusion, as it restores (to some extent) hind foot mechanics, heel height, and bone stock for activities of daily living and future reconstructive options.

Extruded Talus Injuries: A Cross-sectional Survey of Indian Orthopedic Surgeons

“…Although AVN was the most common complication in their series, only one patient with deep infection developed collapse and needed arthrodesis. Mohindra et al 8 also recently reported good outcomes of primary reimplantation for talar extrusions in seven cases. At a mean follow-up of 31.9 months (24-46 months), three patients were able to walk without pain and three patients had mild-to-moderate pain.…”

“…Furthermore, the most common perceived complication in this survey was AVN, which is also the most common complication reported in the literature. [7][8][9]12,13 It is also interesting to note that the majority of the participants were not aware of studies on talar extrusions with longterm outcomes. This emphasizes the need for such studies and multicenter or even international collaboration, to evaluate the outcomes and give more specific guidelines, as the individual experience of most surgeons is limited.…”

“…Furthermore, it preserves bone stock, should the need for future reconstruction arise. [7][8][9] Burston et al 7 retrospectively reviewed nine cases of primary reimplantation of the ET. At a mean follow-up of 42 months (13-72 months), the outcome was good in four patients, fair in two, and poor in one; one patient was lost to follow-up.…”

“…[4][5][6] However, recent literature has shown primary repositioning to be a good treatment modality, with low rates of AVN, infection, and arthrosis. [7][8][9] The aim of this survey was to assess the beliefs and practices of Indian orthopedic surgeons in treating ET injuries, using a cross-sectional survey. We hypothesized that a majority of the surgeons would prefer repositioning of the ET as the primary modality of treatment and that AVN would be reported as the most common complication.…”

Early Reimplantation of Open Total Extruded Talus: A Case Report

“…Some authors, to reduce the risk of infection, postpone talus reimplantation, and use talus-shaped antibiotic cement while waiting for cultural results and then talus implantation done in a staged procedure [ 9 ]. Recent studies suggest that immediate reimplantation with thorough irrigation of wound and debridement of tissue leads to lesser chance of probable postoperative complications such as infection and avascular necrosis [ 9 , 10 ]. We kept extruded talus for 10 min in diluted povidone-iodine solution to get rid of bacterial flora.…”