Reimplantation of total talar extrusions

A Case Report of an Open Pan-Talar Dislocation

“…Open talar extrusion is commonly complicated by soft tissue infection with a potential rate of infection ranges from 25% to 38% of cases [7,11] versus 88.9% initially reported by Detenbeck and Kelly [12]. However, infection risk has been minimized in the recent literature due to improvement in the wound care staged procedures and appropriate antibiotic therapy [6,8].…”

“…Traditionally, the literature described talectomy with tibio-calcaneal arthrodesis as the treatment of choice for an open total talar dislocation. However, recently talar reimplantation after thorough debridement demonstrated satisfying short and long-term clinical outcomes with the advantage of retaining the talar height and bone stock [3][4][5][6][7][8]11,12].…”

Early Reimplantation for Open Total Talar Extrusion

“…Reimplantation of the talus can retain heel height and bone stock, despite having the risks of deep infection and AVN. 1,3,4,[7][8][9]16,21,23,25,27 Nonetheless, in patients with reimplantation of the talus for open total talar extrusion, the risk of developing infection and AVN of talus is high, and thus talectomy should be considered in the initial care. 1,4,8,9,21 However, no infection was noted following irrigation and debridement, reduction of the talus, and cast immobilisation in one such patient.…”

Complete Revascularization of Reimplanted Talus After Isolated Total Talar Extrusion: A Case Report

“…Treatment may consist of talar reimplantation or talar body removal, but the rarity of total talar extrusion has prevented the establishment of a treatment protocol [4][5]. According to several case reports, disruption of the vascular supply and contamination leads to major complications, such as infection and avascular necrosis.…”

“…The high risk of these complications is associated both with the traumatic ankle injury itself and subsequent talar reimplantation [6][7][8]. Although early talectomy with tibiocalcaneal arthrodesis was once recommended as the initial procedure, reimplantation of a completely extruded talus through the wound has been recommended more recently, yielding satisfactory results [4][5][6][7].…”