Six-year survival of reimplanted talus after isolated total talar extrusion: a case report

Abstract

BackgroundOpen total extrusion of the talus without concomitant fracture is an extremely rare injury. We present 6-year follow-up data of a patient treated using a temporary spanning external fixator and less invasive single K-wire fixation.Case presentationA 55-year-old Asian man who had a totally extruded talus without fracture underwent immediate reimplantation surgery. A spanning external fixator with single antegrade K-wire fixation was applied to maintain the reimplanted talus. During 6 years of follow-up, he could walk without aids and could squat, corresponding to an American Orthopaedic Foot and Ankle Society score of 85. We found that the suspect lesion that was evident at 6 months after surgery had disappeared at 12 months postoperatively on the basis of sequential follow-up magnetic resonance imaging. There was no evidence of osteonecrosis of the dislocated talus at the final follow-up.ConclusionsIn patients with a totally extruded talus, a surgical strategy including immediate reimplantation of the talus and a temporary spanning fixator with single K-wire fixation might be useful to allow early mobilization around the ankle joint and to prevent additional damage of the foot without significant complications.

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“…Kwak, et al reported revascularisation of a completely extruded talus with serial MRI scans after prompt reimplantation. They did not report any soft tissue problems in achieving the desired outcome [30]. A systemic review in 2015 reporting on 39 articles with 86 cases showed that 84% had open injuries and 12% had associated fractures other than talus.…”

Highly contaminated extruded talus. Is it safe to reimplate? A case report.

“…The failure of the medial bony stabilizer allows talus extrusion. In most of the reported cases, it remained attachments, especially deltoid ligament 2,6 . There was no strong evidence-based procedure.…”

Talus

“…Liegt eine nicht zu rekonstruierende Zertrümmerung des Talus vor, so sollte trotzdem keine primäre Astragalektomie, sondern eine Erhaltung im Sinne einer primären oder frühsekundären Arthrodese des oberen und unteren Sprunggelenkes angestrebt werden. Dies gilt auch für die traumatische Talusextrusion, nach der dieser primär im Sinne eines "Spacers" wieder eingebracht werden kann [29,30].…”