Arthrodesis Techniques for Avascular Necrosis of the Talus

Management of Nonunited Talar Fractures With Avascular Necrosis by Resection of Necrotic Bone, Bone Grafting, and Fusion With an Intramedullary Nail

“…1 Fusion of the ankle and subtalar joint as a salvage procedure carries a substantial risk for nonunion. 5,18 Many authors recommend the resection of all necrotic bone as an integral part of the procedure. 12,16-18,20 Curettage and bone graft or arthroscopic ankle fusion are suitable options only in less extensive AVN affecting less than 50% of the talar dome.…”

“…5,18 Many authors recommend the resection of all necrotic bone as an integral part of the procedure. 12,16-18,20 Curettage and bone graft or arthroscopic ankle fusion are suitable options only in less extensive AVN affecting less than 50% of the talar dome. 9,18 In these rare cases, the subtalar joint can be preserved if it is not involved with the necrosis.…”

“…12,16-18,20 Curettage and bone graft or arthroscopic ankle fusion are suitable options only in less extensive AVN affecting less than 50% of the talar dome. 9,18 In these rare cases, the subtalar joint can be preserved if it is not involved with the necrosis. However, even with these guidelines, Kendal et al 9 reported that 20% of patients who underwent arthroscopic ankle fusion for nonextensive AVN (3 of 15 patients) required subsequent subtalar arthrodesis.…”

“…The approaches used for tibiotalocalcaneal fusion vary in the literature. Lateral transfibular, 8,11,18,20 combined lateral and medial, 3 and combined anterior and lateral 8,20 approaches have been reported. In the study presented, the posterior midline approach to the ankle was used because it has several advantages.…”

Retrograde Intramedullary Nail Arthrodesis for Avascular Necrosis of the Talus

“…Some authors have warned of a higher risk of nonunion when fusing the ankle joint Copyright © 2010 by the America in the face of AVN, 5 thus others have found that a tibiotalocalcaneal arthrodesis may be more successful in cases of total body involvement. 30 Blair reported in 1943 on a tibiocalcaneal arthrodesis with sliding tibia! onlay as a primary treatment for severe talar fractures.…”