Talus avascular necrosis

OBJECTIVE: To summarize the surgical treatment methods for avascular necrosis of the talus. METHODS: The recent domestic and international literature related to avascular necrosis of the talus was extensively conducted. The pathogenesis, surgical treatment methods, and prognosis were summarized. RESULTS: The clinical symptoms of avascular necrosis of the talus at early stage are not obvious, and most patients have progressed to Ficat-Arlet stages Ⅲ-Ⅳ and require surgical treatment...

Aim The present study aims to look at the long-term clinical and radiological outcomes of surgically treated talus fractures. We have compared the outcomes and complications between simple and complex talar fracture patterns. Additionally, patients' ability to return to activity following surgical treatment of these fractures was also analysed. Materials and methods Retrospective analysis of surgically treated talus fractures at the PSG Institute of Medical Sciences and Research from 2012 to 2015. The fractures were classified as neck and body fractures...

BACKGROUND: Talar neck fractures are rare but potentially devastating injuries, with early reduction and rigid fixation essential to facilitate union and prevent avascular necrosis. Even small degrees of malunion will alter load transmission and subtalar joint kinematics. Changes in fixation techniques have led to dual plating strategies. While locked plating has perceived advantages in porotic bone and comminution, its biomechanical benefits in talar neck fractures have not been shown...

BACKGROUND: Joint salvage surgeries such as tibiotalocalcaneal arthrodesis and talar prosthesis are commonly used in the surgical treatment of collapsed avascular necrosis of the talus (AVNT). However, differences in outcomes of these 2 surgical treatments are still inconclusive. This study compared the 10- to 13-year outcomes and 10-year survivorship rates of tibiotalocalcaneal arthrodesis and talar body prosthesis in the surgical treatment of collapsed AVNT. METHODS: A retrospective comparative study was conducted of patients who underwent either tibiotalocalcaneal arthrodesis or talar body prosthesis implantation between 2005 and 2012...

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A woman in her 40s was involved in a motor vehicle collision and sustained a closed Hawkins type IV talar neck fracture dislocation. The injury was treated with reduction, percutaneous pinning and spanning external fixation, followed by definitive treatment with total talus arthroplasty (TTA) 2 months following injury. This is a unique example of definitive management for a severe talar neck fracture dislocation with arthroplasty in the subacute setting. TTA is perhaps a primary option for these injuries at high risk for avascular necrosis, non-union, malunion and post-traumatic arthritis...

INTRODUCTION: Bilateral talar fracture- dislocations with concomitant medial malleolus fractures are rare and present complex challenges. CASE REPORT: We present a case study of a 30-year-old male painter who sustained these injuries following a significant fall. The surgical intervention included open reduction and internal fixation with a cannulated cancellous (CC) screw on one side and percutaneous fixation after closed reduction on the other. CONCLUSION: The patient's patient's three3-year follow-up revealed excellent ankle function and minimal avascular necrosis changes, demonstrating the importance of well-planned delayed therapy over hasty acute procedures...

BACKGROUND: This retrospective cohort study aimed to investigate the natural history of talar avascular necrosis (AVN) during short-term outpatient follow-up and to identify the risk factors for progression to collapse and arthritic changes. METHODS: Thirty-four cases of talar AVN from 34 patients (15 males, 19 females) were included. The mean age of the patients was 48.9 years (SD 16.0 years) and the mean follow-up period was 39.5 months (SD 42.0 months). The patients were divided into two groups i...

BACKGROUND: Prosthetic substitution of the talus presents a significant challenge to the foot and ankle surgeon. The shear and compressive forces on the talus and its tenuous blood supply lead to high rates of avascular necrosis and eventual talar collapse. The purpose of this systematic review is to evaluate whether total ankle total talus replacement (TATTR) leads to improved clinical and radiographic outcomes with appropriate safety metrics in patients with a history of avascular necrosis or significant trauma...

A 34-year-old healthy long-distance runner sustained a possible stress injury to the talus. This injury progressed into osteonecrosis (ON) or might have presented idiopathically. This patient had a complete normal metabolic workup. Non-surgical management, including resting, activity modification, and bone stimulators, led to resolution. Serial exams and magnetic resonance imaging demonstrated gradual resolution of the ON. At two years old, she was pain-free and had returned to running. Talus ON is uncommon and even more so in the absence of metabolic disorders or precipitating trauma...

Fractures of the talus are infrequent injuries often associated with substantial morbidity and imperfect outcomes. We undertook a retrospective review of talus fractures at multiple level 1 trauma centers in order to identify common treatment patterns and potential predictors of complications. All cases of talar fractures meeting inclusion criteria at our institution were reviewed. 54 of 103 talus fractures met inclusion criteria. 33 (61.1%) involved the talar neck, 13 (24.1%) the talar body, and 6 (9.2%) involved the lateral process...

The foot and ankle serve vital roles in weight bearing, balance, and flexibility but are susceptible to many diverse ailments, making treatment difficult. More commonly, Total Ankle Arthroplasty (TAA) and Total Talus Replacement (TTR) are used for patients with ankle degeneration and avascular necrosis of the talus, respectively. Ankle prosthesis and orthosis are also indicated for use with lower limb extremity amputations or locomotor disability, leading to the development of powered exoskeletons. However, patient outcomes remain suboptimal, commonly due to the misfitting of implants to the patient-specific anatomy...

Total talar extrusion is a rare complication of high-energy traumas. A consequence of this injury can be avascular necrosis (AVN) of the talus. Patients are confronted with pain, limited range of motion and post-traumatic arthritis. As AVN progresses the talus is gradually destroyed. This report presents the use of a chimeric medial femoral condyle chondro-osseus flap with two thin periosteal flaps to increase vascular supply to the traumatized area, accelerate bone formation, flap integration, and restore articular surfaces in a patient with partial necrosis of talar body...

Lateral subtalar dislocations are rare and severe injuries caused by high-energy trauma, and they require urgent treatment. We reported two cases of lateral subtalar dislocation, which were treated with different methods. In case of open lateral subtalar dislocation, we used the method of distractional external fixation; the final outcome was good, without avascular necrosis of the talus. The case of closed subtalar dislocation has been treated with open reduction and K-wires fixation. The final outcome was poor, with avascular necrosis of the talus...

Osteonecrosis is a devastating complication of long-term glucocorticoid therapy that has been described in both malignant and nonmalignant diseases. Its incidence has been found to greater than 50% using magnetic resonance imaging in asymptomatic patients, thus osteonecrosis is likely underdiagnosed. Recent studies have suggested that treatment with bisphosphonates can improve pain and mobility and decrease bone marrow edema. We describe a patient with acute lymphoblastic leukemia who presented with debilitating osteonecrosis after treatment with prednisone for a total cumulative dose of 5100 mg...

BACKGROUND: As total talus replacement (TTR) grows in popularity as a salvage option for talar collapse, a critical evaluation of the complications associated with this procedure is indicated. METHODS: In this review of the literature, we present a patient report and provide a review of several complications seen after TTR, including ligamentous instability, infection, and adjacent joint osteoarthritis, which we have encountered in our practice. RESULTS: Total talus replacement has the potential to reduce pain and preserve range of motion...

OBJECTIVE: To investigate the clinical effect of the anteromedial cannulated screw approach in the treatment of Hawkins II/III talus fractures in children. METHODS: A retrospective study was conducted on 20 children with talar fractures admitted to Renmin Hospital from September 2018 to February 2022. The fracture healing and functional recovery of the affected limb were strictly followed up after the operation. There were 14 males and 6 females. The average age was 9 years (range 6-12 years)...

Avascular necrosis (AVN) of the talus is a difficult pathology to treat. Patient-specific factors such as functional status, comorbidities should be considered. Previous standard care for talar AVN was centered around arthrodesis procedures and loss of motion about the joints of the rearfoot and ankle. With the advent of 3D printed talar implants, patients are afforded an option to maintain ankle joint motion. Literature is limited due to the recent development of total talus replacement (TTR) technology. This article aims to review literature, surgical techniques, and pearls to better help foot and ankle surgeons treat cases of talar AVN...

Ankle arthrodesis has been a time-tested procedure for osteoarthritis, avascular necrosis of the talus, deformity correction, and significant trauma of the ankle. Technique guides have created dissection pearls, ease of fixation, and arthroscopic techniques to mitigate complications of the procedure. Major complications, such as nonunion, malunion, or implant infection are the most worrisome and cumbersome complications to handle. The aim of this article is to provide the practicing surgeon evidence to provide innovative management techniques for nonunion, malunion, and infection following primary ankle arthrodesis...

Total talus replacement is a promising alternative treatment for talus fractures complicated by avascular necrosis and collapse. This surgical option replaces the human talus bone with a customized talus implant and can maintain ankle joint functionality compared to traditional treatment (e.g., ankle fusion). However, the customized implant is costly and time-consuming due to its customized nature. To circumvent these drawbacks, universal talus implants were proposed. While they showed clinically satisfactory results, existing talus implants are heavier than biological talus bones as they are solid inside...