Tibiocalcaneal fusion for avascular necrosis of the talus

Dennison, M; Pool, R. D.; Simonis, R. B.; Singh, Baldeep

doi:10.1302/0301-620x.83b2.11500

Cited by 57 publications

(46 citation statements)

References 8 publications

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“…[7][8][9] Although this procedure minimises the need for shortening, instability of the hindfoot remains and often leads to a pseudarthrosis. 10 Tibiocalcaneal fusion appears to produce favourable functional results, but at the expense of shortening. Dennison et al 10 and Kovoor et al 11 reported tibiotalar or tibiocalcaneal fusion for patients with bone loss of the talus combined with callotasis using the Ilizarov technique, which makes these operations technically demanding.…”

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confidence: 99%

The use of a ceramic talar body prosthesis in patients with aseptic necrosis of the talus

Taniguchi

Takakura

Sugimoto

et al. 2012

The Journal of Bone and Joint Surgery. British volume

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The purpose of this study was to evaluate the clinical results of a newly designed prosthesis to replace the body of the talus in patients with aseptic necrosis. Between 1999 and 2006, 22 tali in 22 patients were replaced with a ceramic prosthesis. A total of eight patients were treated with the first-generation prosthesis, incorporating a peg to fix into the retained neck and head of the talus, and the remaining 14 were treated with the second-generation prosthesis, which does not have the peg. The clinical results were assessed by the American Orthopaedic Foot and Ankle Society ankle/hindfoot scale. The mean follow-up was 98 months (18 to 174). The clinical results of the first-generation prostheses were excellent in three patients, good in one, fair in three and poor in one. There were, however, radiological signs of loosening, prompting a change in design. The clinical results of the second-generation prostheses were excellent in three patients, good in five, fair in four and poor in two, with more favourable radiological appearances. Revision was required using a total talar implant in four patients, two in each group. Although the second-generation prosthesis produced better results, we cannot recommend the use of a talar body prosthesis. We now recommend the use of a total talar implant in these patients.

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mentioning

confidence: 99%

The use of a ceramic talar body prosthesis in patients with aseptic necrosis of the talus

Taniguchi

Takakura

Sugimoto

et al. 2012

The Journal of Bone and Joint Surgery. British volume

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“…If osteonecrosis develops and is symptomatic, a modified Blair arthrodesis or tibiotalar arthrodesis has had reasonable success [15,16,17] .…”

Section: Discussionmentioning

confidence: 99%

“…An established osteomyelitis of the talus may be resistant to treatment because it is composed almost entirely of cancellous bone and is largely devoid of blood supply after fracture through the neck. The preferred treatment in fractures complicated by infection is excision of the infected bone followed by arthrodesis [16,17,25] .…”

Section: Discussionmentioning

confidence: 99%

Clinical and surgical outcome following surgical management of talar neck fractures

R¹

2018

Int. J. Orthop. Sci.

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Fractures of the talar neck & body remain a challenge to the treating surgeon due to the serious nature of the injury and to the potential complications of the treatment. Displaced fracture of the talar neck is associated with a high percentage of permanent disability. The key for the treatment of talus fracture is knowledge of anatomy and the blood supply Aim of the Study: The aim of the study was to analyze Incidence, age, sex, mechanism of injury, Types of fractures and dislocations, Effectiveness of different methods of fixation, period for union of fractures, complications and their management, Functional outcome. Clinical Material and Methods: Forty two patients were treated for fracture of talar neck at our institution. This study was conducted retrospectively and prospectively Fractures were classified according to HAWKIN'S classification with modification from S. Terry Canale. Three of them belong to type one (undisplaced); eighteen were type 2; nineteen were type 3; two type 4. The compound factures were classified according to Gustillo and Anderson. Road traffic accident was the cause of trauma in twenty two, fall from height being cause of injury in nineteen, one patient had fall of stone slab on the foot. Treatment: Forty patients underwent surgery for the fixation of talar neck fractures. Thirty four of the fractures were operated with in twenty four hours after injury of the 40 patients who underwent fixation, open reduction and internal fixation was done in thirty two patients (seventeen type 3, twelve type 2, two type 4, one type 1). Cannulated /cancellous screws were used to fix talus in seventeen patients (16 antegrade, anteromedial to posterolateral. One posterolateral to anteromedial), Orthofix pins were used in eleven patients, K-wire used in twelve of them. All the fractures were evaluated at the end of six weeks after surgery. Plaster cast removed and radiological evaluation of the fracture was done and below knee cast re applied. In the evidence of fracture union active mobilisation started with strict non weight bearing continued until sound fracture union. Conclusion: Clinical management of the talar neck fractures is complex. Prompt and precise anatomic surgical reduction, preservation of the blood supply, bone grafting of the medial neck comminution, rigid internal fixation to allow joint mobilization post operatively are the guidelines to be followed to reduce poor outcomes.

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“…Tibiocalcaneal arthrodesis was introduced by Blair as a treatment for this condition [15] but has the disadvantages of loss of function and shortening of the limb [16, 17]. The procedure also requires a long recovery period and carries a considerable risk of pseudarthrosis [2, 3, 18], and a large amount of bone needs to be harvested when an iliac bone graft is used.…”

Section: Discussionmentioning

confidence: 99%

Custom-Made Alumina Ceramic Total Talar Prosthesis for Idiopathic Aseptic Necrosis of the Talus: Report of Two Cases

Tonogai

Hamada

Yamasaki

et al. 2017

Case Reports in Orthopedics

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Two women aged 65 years and 78 years presented to our center with idiopathic necrosis of the talus. In both cases, imaging examinations showed collapse and sclerotic changes of the talar body caused by the necrosis. Both women underwent resection and placement of a third-generation custom-made alumina ceramic total talar prosthesis. Immobilization of the ankle in a short-leg cast for 3 weeks was followed by early rehabilitation. One year and 6 months after surgery, both women were able to walk without pain. Their Japanese Society for Surgery of the Foot ankle-hindfoot scale scores improved from 22 and 29/100 points to 90 and 95/100 points, respectively. To the best of our knowledge, the successful treatments of these two rare cases of idiopathic necrosis of the talus are among only a few reported cases of using a third-generation alumina ceramic prosthesis.

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Tibiocalcaneal fusion for avascular necrosis of the talus

Cited by 57 publications

References 8 publications

The use of a ceramic talar body prosthesis in patients with aseptic necrosis of the talus

The use of a ceramic talar body prosthesis in patients with aseptic necrosis of the talus

Clinical and surgical outcome following surgical management of talar neck fractures

Custom-Made Alumina Ceramic Total Talar Prosthesis for Idiopathic Aseptic Necrosis of the Talus: Report of Two Cases

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