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Talus avascular necrosis

Ümit Aygün, Yalkçn Çalçk, Barçş Alkan, Cengiz Işçk
In this study, we present the case of a 42-year-old man with a fracture and dislocation of the left talus neck, and a fracture of the right talus neck due to a fall. This kind of fracture can be considered rare, and thus few cases have been reported. Fracture fixation was provided through cannulated screws on either side. Splints were removed after 6 weeks, and passive/active joint movement exercises were started. The patient was able to walk with partial weightbearing at 2 months and with full weightbearing at 3 months...
September 2, 2016: Journal of the American Podiatric Medical Association
Ewout S Veltman, Ernst Ja Steller, Philippe Wittich, Jort Keizer
A case of complicated lateral subtalar dislocation is presented and the literature concerning this injury is reviewed. Subtalar joint dislocations are rare and often the result of a high-energy trauma. Complications include avascular necrosis of the talus, infection, posttraumatic osteoarthritis requiring arthrodesis and chronic subtalar instability. Negative prognostic factors include lateral and complicated dislocations, total talar extrusions, and associated fractures. A literature search was performed to identify studies describing outcome after lateral subtalar joint dislocation...
September 18, 2016: World Journal of Orthopedics
Ji-Cheng Gong, Bing-Hua Zhou, Xu Tao, Cheng-Song Yuan, Kang-Lai Tang
BACKGROUND: Tibiotalocalcaneal arthrodesis with headless compression screws has not been previously reported. We hypothesized that these screws could be suitable for tibiotalocalcaneal arthrodesis because of their special design. This study aimed to evaluate the clinical outcomes of patients undergoing tibiotalocalcaneal arthrodesis with headless compression screws for the treatment of severe arthropathy of the ankle and subtalar joint. METHODS: From 2010 to 2015, 23 patients with severe ankle and subtalar arthropathy underwent tibiotalocalcaneal arthrodesis...
2016: Journal of Orthopaedic Surgery and Research
Benjamin Johnson, Nick Rouholamin, Amit Patel
Total talar dislocations, in which the talus is dislodged from all three of its articulations are rare, comprising only 3.4% of all major talar injuries. The most common complications are osteomyelitis and avascular necrosis. The current literature on total talar dislocations is based on small series and case reports. This literature review outlines the anatomy and blood supply to the talus and discusses the mechanism of injury, presentation, treatment and complications associated with total dislocations of the talus...
December 2012: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Kyle S Peterson, W Drew Chapman, Christopher F Hyer, Gregory C Berlet
Tibiotalocalcaneal arthrodesis is a salvage procedure for severe hindfoot/ankle deformities, arthritis, avascular necrosis of the talus, failed total ankle replacement, and Charcot neuroarthropathy. The methods for fixation include anterior and lateral plates, screws, retrograde intramedullary nails, and external fixation. The purpose of the present report was to describe the short-term radiographic outcomes and technique using a posterior approach with an anatomic-specific locking plate for tibiotalocalcaneal arthrodesis...
September 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Michael A Maceroli, Christopher Wong, Roy W Sanders, John P Ketz
OBJECTIVES: To assess the healing and radiographic outcomes of displaced and comminuted talar neck fractures treated with medial position screws augmented with lateral minifragment plate fixation. DESIGN: Retrospective case series. SETTING: Two level I trauma centers. PATIENTS: The records of 26 patients with displaced and comminuted talar neck fractures who underwent open reduction and internal fixation with medial-sided position screws augmented with lateral minifragment plates...
October 2016: Journal of Orthopaedic Trauma
Ricardo Jorge Gomes de Sousa, Ricardo Pedro Ferreira Rodrigues Pinto, Marta Maria Teixeira de Oliveira Massada, Manuel Alexandre Negrais Pinho Gonçalves Pereira, José Muras Geada, Isabel Maria Gonçalves Costa
Talus fractures often lead to late post-traumatic arthrosis. In such cases, the use of latest generation, cementless prostheses has been hindered by the presence of avascular necrosis. We report the case of a 65-year-old patient who presented four years after a talus neck fracture. He had painful ankle arthrosis (AOFAS ankle-hindfoot score 19) and avascular necrosis, with collapse of the entire talar dome. Given the extent of the necrosis, it was decided to cement the talus prosthetic component. One year after the surgery, the patient shows good clinical and radiological results (AOFAS ankle-hindfoot score 87) and is satisfied with the procedure...
January 2011: Revista Brasileira de Ortopedia
Ricardo Jorge Gomes de Sousa, Marta Maria Teixeira de Oliveira Massada, Manuel Alexandre Negrais Pinho Gonçalves Pereira, Isabel Maria Gonçalves Costa, José Fernando Souzellas da Costa E Castro
OBJECTIVES: Talar neck and body fractures are unusual fractures. The purpose of this study is to determine the prevalence of long term results. MATERIAL AND METHODS: A retrospective analysis was carried out including 11 patients that underwent surgical treatment for body or neck talus fractures between January 1997 and December 2005. Final follow-up examination included a clinical evaluation (AOFAS score) and standard radiographs. RESULTS: The mean follow-up time was 58...
January 2009: Revista Brasileira de Ortopedia
Kai Wu, Zihui Zhou, Jianhua Huang, Jian Lin, Qiugen Wang, Jie Tao
We describe a highly selective incision combined with percutaneous manipulation for reduction and internal fixation of talar neck fractures. We retrospectively investigated the clinical data from 29 cases of talar neck fractures treated from January 2009 to June 2013. Fifteen patients (study group) were treated using a 1- to 2-cm limited incision placed on the anteromedial or anterolateral side of the talus, followed by percutaneous reduction and fixation. Another 14 patients (control group) underwent open reduction and internal fixation through a conventional anteromedial or anterolateral approach...
May 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
François Ruhlmann, Camille Poujardieu, Joel Vernois, Louis-Etienne Gayet
Isolated acute traumatic subtalar dislocations are quite rare. They correspond to talotarsal dislocation, including the talonavicular and talocalcaneal joints. The purpose of the present study was to evaluate the functional and radiologic outcomes of the treatment of acute traumatic isolated subtalar dislocations. The present retrospective study included 13 patients who had sustained isolated subtalar dislocations during a 10-year period. Of the 13 cases, 10 (76.9%) were medial dislocations and 3 (23.1%) were lateral dislocations...
March 2, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Manuel J Pellegrini, Adam P Schiff, Samuel B Adams, James K DeOrio, Mark E Easley, James A Nunley
BACKGROUND: A number of operative approaches have been described to perform a tibiotalocalcaneal (TTC) arthrodesis. Here we present the largest reported series of a posterior Achilles tendon-splitting approach for TTC fusion. METHODS: With institutional review board approval, a retrospective review of the TTC fusions performed at a single academic institution was carried out. Orthopedic surgeons specializing in foot and ankle surgery performed all procedures. Eligible patients included all those who underwent a TTC fusion via a posterior approach and had at least a 2-year follow-up...
March 2016: Foot & Ankle International
Dane K Wukich, Katherine M Raspovic, Kimberlee B Hobizal, David Sadoskas
BACKGROUND: Charcot neuroarthropathy (CN) of the ankle and hindfoot (Sanders/Frykberg Type IV) is challenging to treat surgically or nonsurgically. The deformities associated with ankle/hindfoot CN are often multiplanar, resulting in sagittal, frontal and rotational malalignment. In addition, shortening of the limb often occurs from collapse of the distal tibia, talus and calcaneus. These deformities also result in significant alterations in the biomechanics of the foot. For example, a varus ankle/hindfoot results in increased lateral column plantar pressure of the foot, predisposing the patient to lateral foot ulceration...
January 2016: Diabetes/metabolism Research and Reviews
J J M Haverkort, L P H Leenen, K J P van Wessem
INTRODUCTION: Talar fractures are a rare type of fractures (less than 1%). They are difficult to treat and outcome is often complicated by arthritis and avascular necrosis. In this article three cases are presented with different types of dislocated talar neck fractures. Anatomy of the talus, treatment, outcome and follow up of these fractures are discussed. Further, review of literature and guidelines for treatment and follow up for dislocated talar neck fractures are discussed. DISCUSSION: The risk of developing arthritis or avascular necrosis of the talus after dislocated talar neck fractures depends on the initial trauma with vascular compromise due to dislocation of the talus...
2015: International Journal of Surgery Case Reports
Yu Min Suh, Jun Young Choi, Kyung Ah Chun, Jin Soo Suh
Osteonecrosis, also known as avascular necrosis or osteochondrosis, refers to the death of bone tissue resulting from a to lack of blood supply. Osteonecrosis of the foot is most commonly seen in the talus and metatarsals and not as frequently in other bones. We report an extremely rare case of late-onset osteonecrosis of the proximal phalangeal head of the great toe in a 9-year-old male. Plain radiographs and computed tomography did not show any findings of osteonecrosis initially. However, because of persistent pain at the interphalangeal joint of the first toe and a decrease in the range of movement at the interphalangeal joint at 7 months after injury, the patient underwent additional examination with repeated radiographs and magnetic resonance imaging...
September 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Jian-Shui Mao, Zhao-Ming Ye
OBJECTIVE: To explore the relationship of the classification of talus fracture and surgery methods with avascular necrosis. METHODS: From March 2009 to November 2013, 78 patients with talus fracture were treated, of them, 43 cases were followed up from 2 to 5 years. There were 27 males and 16 females, aged from 17 to 65 years old with the mean of 38.6 years. Thirty-nine cases had talar neck injury and 4 cases had talar body injury. Different treatments were performed according to different injury conditions...
April 2015: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Markus Knupp, Lukas Zwicky, Tamara Horn Lang, Julian Röhm, Beat Hintermann
The medial approach to the subtalar joint allows good visualization of the articular surfaces. Compared with the lateral approach, advantages are found particularly in flatfoot correction, in which the single-incision technique can be used for corrective fusions of rigid flatfoot deformity. Union rates are comparable with the traditional lateral approach; however, wound healing problems occur less frequently. Avascular necrosis of the talus is a rare but serious complication, although frequency seems to be independent of the approach chosen...
June 2015: Foot and Ankle Clinics
Stefan Rammelt, Jens Goronzy
Subtalar dislocations make up 1-2% of all dislocations, about 75% of them being medial dislocations. Treatment consists of early reduction under adequate sedation. In cases of soft tissue interposition or locked dislocations, open reduction is warranted. More than 60% of subtalar dislocations are associated with additional fractures, therefore a postreduction CT is recommended. Complications include avascular necrosis of the talus, infection, posttraumatic arthritis, chronic subtalar instability, and complex regional pain syndrome with delayed reduction...
June 2015: Foot and Ankle Clinics
John T Weston, Xiaochen Liu, Meghan E Wandtke, Jiayong Liu, Nabil E Ebraheim
This review summarizes the treatment and resulting outcomes for total talar dislocation. The PubMed database was searched for articles about humans with total talar dislocation published in the English language in the last twenty years. The following data were entered into a Microsoft Excel spreadsheet: type of dislocation, nature of associated fractures (if any), type of reduction/fixation utilized, immobilization, weight-bearing status, outcome, complications and average follow-up time. Thirty-nine articles reporting a total of 86 cases of total talar dislocation are included in this review...
May 2015: Orthopaedic Surgery
N Kodama, Y Takemura, H Ueba, S Imai, Y Matsusue
A new method of vascularised tibial grafting has been developed for the treatment of avascular necrosis (AVN) of the talus and secondary osteoarthritis (OA) of the ankle. We used 40 cadavers to identify the vascular anatomy of the distal tibia in order to establish how to elevate a vascularised tibial graft safely. Between 2008 and 2012, eight patients (three male, five female, mean age 50 years; 26 to 68) with isolated AVN of the talus and 12 patients (four male, eight female, mean age 58 years; 23 to 76) with secondary OA underwent vascularised bone grafting from the distal tibia either to revascularise the talus or for arthrodesis...
June 2015: Bone & Joint Journal
Orhan Akıncı, Yavuz Akalın
OBJECTIVE: This study aimed to evaluate the implementation, in a single session, of both massive posteromedial release and triple arthrodesis for rigid neglected clubfoot deformities in adult patients, and its effects on clinical and radiological results. METHODS: The procedures were performed in one session on 15 feet of 11 patients [7 male, 4 female; mean age 26 (range: 15 to 50)]. Staples were used for fixation in all patients. For clinical assessment, the AOFAS (American Orthopaedic Foot and Ankle Society) ankle- hindfoot scale was used...
2015: Acta Orthopaedica et Traumatologica Turcica
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