Bipartite talus: a case series and algorithm for treatment

B Rose, C Southgate, L Louette
Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons 2013, 19 (2): 96-102

BACKGROUND: Bipartite talus is a rare condition of uncertain aetiology, with various treatment options described.

METHODS: We report five symptomatic bipartite talus cases in four male patients warranting surgical management. All patients were reviewed by an independent assessor.

RESULTS: The youngest patient presented with bilateral lesions without sub-talar arthrosis. He was treated twice by internal fixation with bone grafting. The left side failed to unite. The second patient presented with isolated sub-talar osteoarthritis. He underwent fragment excision and sub-talar arthrodesis with bone graft. The third patient presented aged 55 with severe hind-foot osteoarthritis, and underwent tibio-talar-calcaneal fusion. The final patient was treated with fragment excision and sub-talar arthrodesis. All patients reported symptom improvement or resolution post-operatively. Four cases showed evidence of radiographic union.

CONCLUSIONS: We suggest a treatment rationale of fragment fusion if large enough, or excision if not, with associated limited fusion if the adjacent joints are markedly degenerate.

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