Outcomes of a Reimplanted Talus After a Total Open Extrusion

Issaoui, Hichem; Fekhaoui, Mohammed-Reda; Abbassi, Hatem; Gargouri, Mahdi; Ali, Mazen

doi:10.7759/cureus.9678

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…Some authors, to reduce the risk of infection, postpone talus reimplantation, and use talus-shaped antibiotic cement while waiting for cultural results and then talus implantation done in a staged procedure [ 9 ]. Recent studies suggest that immediate reimplantation with thorough irrigation of wound and debridement of tissue leads to lesser chance of probable postoperative complications such as infection and avascular necrosis [ 9 , 10 ]. We kept extruded talus for 10 min in diluted povidone-iodine solution to get rid of bacterial flora.…”

Section: Discussionmentioning

confidence: 99%

Early Reimplantation of Open Total Extruded Talus: A Case Report

Wooly,

Kumar,

Mane

et al. 2024

jocr

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Introduction: Traumatic open total extrusion of talus without soft-tissue attachment and not associated with surrounding fracture is a very rare injury which requires very high energy impact. In literature, optimal treatment protocols are yet to be established. A few options described in literature are talectomy and tibiocalcaneal arthrodesis or reimplantation of talus which may be immediate or after some interval. Case Report: A 28-year-old female suffered road traffic accident and had total open extrusion of talus without soft-tissue attachment, and we managed it with thorough debridement of the wound, saline irrigation, and immediate reimplantation of the talus with stabilization by delta frame external fixator. Proper pre- and post-operative antibiotic coverage was given as per protocol. We did not face post-operative infection, wound complication, and until 12 months followed up, there are some signs of avascular necrosis of the talus but the good functional outcome. Conclusion: With this case experience, we suggest that this is the valid treatment protocol for total extrusion of the talus, and it will provide a better hindfoot mechanism, heel height, and the patient can resume his/her daily routine activity as early as possible. Keywords: Tibiocalcaneal arthrodesis, talar extrusion, avascular necrosis of talus

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Section: Discussionmentioning

confidence: 99%

Early Reimplantation of Open Total Extruded Talus: A Case Report

Wooly,

Kumar,

Mane

et al. 2024

jocr

View full text Add to dashboard Cite

show abstract

“…A free flap cover was done to cover the defect and recorded a favorable outcome. Hichem et al [ 25 ] recorded complete revascularization and satisfactory outcomes in a 30-year-old man after talus reimplantation following total talar extrusion. The key to a satisfactory outcome is thorough wound debridement and fixation.…”

Section: Discussionmentioning

confidence: 99%

Extruded Fracture Dislocation of Talus, A Rare and Devastating Injury. A Series of Five Cases

Gupta,

Rai,

Vij

et al. 2024

jocr

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Introduction: Extrusion of the talus with fracture dislocation is a very rare and devastating ankle injury usually caused by high-energy impact. There is no common consensus on the management for this type of injury. We intend to report on our experiences with its management and outcomes. Case Report: We received a total of five cases of extruded fracture dislocation of the talus between March 2016 and April 2020. All fracture talus was Hawkins Type IV fracture. All five patients were male with an age range between 18 and 54 years and have sustained an injury in road traffic accidents. They were managed with wound debridement, talar preservation open reduction, and internal fixation with an application of an external fixator for wound care. All were followed up for 2 years. Conclusion: Extruded fracture dislocation of the talus is a rare and devastating ankle injury. Its management is time-dependent and involves meticulous planning for a favorable outcome. Keywords: Extruded fracture dislocation of talus, devastating ankle injury, open talus fracture dislocation, ankle injury.

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Treatment of open extruded fracture neck of the talus using the combined method of external fixation modified for dynamic ankle joint fixation and Kirschner wires

Božović,

Lalić,

Petrović

et al. 2024

Sanamed

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Introduction: Open extruded fractures of the talus occur in 2% of talar fractures. These fractures are challenging for surgeons due to complications such as infection, nonunion, and arthritis. The most common treatment method is talus reimplantation and osteosynthesis. Case report: A 19-year-old presented with an open extruded fracture of the talus, classified as Hawkins II, following a fall from a height. Emergency surgery involved wound debridement, talus reimplantation, osteosynthesis with modified external fixation for dynamic ankle joint fixation (Mitkovic-type), and two Kirschner wires. Fragments were repositioned under C-Arm fluoroscopy. The patient received a 14-day antibiotic regimen (Cephalosporins, Aminoglycoside, Metronidazole) and thromboembolic prophylaxis for 35 days. After 6 weeks we allowed movements in the ankle joint with physical therapy. Gradual weight-bearing was allowed after 8 weeks. The osteosynthetic material was removed after 18 weeks, with full weight-bearing achieved after 6 months. Radiographic follow-up was conducted up to 24 months postoperatively, showing excellent healing with minimal dorsiflexion restriction. Conclusions: Treating this injury is a significant challenge. External fixation can be a viable method for managing open luxation fractures of the talus.

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Outcomes of a Reimplanted Talus After a Total Open Extrusion

Abstract: Issaoui et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Cited by 3 publications

References 17 publications

Early Reimplantation of Open Total Extruded Talus: A Case Report

Early Reimplantation of Open Total Extruded Talus: A Case Report

Extruded Fracture Dislocation of Talus, A Rare and Devastating Injury. A Series of Five Cases

Treatment of open extruded fracture neck of the talus using the combined method of external fixation modified for dynamic ankle joint fixation and Kirschner wires

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