The Blood Supply of the Talus

Abstract

Fronz the No/field Orthopaedic ('entre, Oxford, Englaizd It has long been known that avascular necrosis of the talus may occur as a sequel to certain fractures and dislocations. Consequently the blood supply to the talus has been the subject of considerable investigation. The arterial supply to the talus has been well described in most of its aspects but the arterial distribution and the anastomoses within the bone have not been elucidated completely despite their significant surgical implications. The present study was undertaken because modern techniques are particularly applicable in showing the extraosseous aIld intraosseous arterial supply. The first attempt to inject the vessels of the talus with a radiopaque substance and to study their distribution radiologically was by Lexer, Kuliga and Turk (1904). They said that THE JOURNAL OF BONE AND JOINT SURGERY 164 WALTER MERCER BIRTHDAY VOLUME THE JOURNAL OF BONE AND JOINT SURGERY 46, 720.

What Happens to the Articular Surface After Curettage for Epiphyseal Chondroblastoma? A Report on Functional Results, Arthritis, and Arthroplasty

“…Hence, femoral head nutrition is reliant on preserving the integrity of the retinacular vessels, which can be disrupted during the surgical approach. Similarly, the talus has two features that relate to its nutrition: a high percentage of surface covered by articular cartilage and a retrograde blood supply [17]. Like displaced fractures of the talar neck, a direct approach through a bone window may disrupt the arteries to the tarsal canal and to the tarsal sinus, which are the main vascular supply.…”

Anatomical reconstruction of malunited talus fractures

“…In any case, careful soft tissue dissection is mandatory. To expose the talar body, we performed osteotomy of the medial malleolus rather than extensive soft tissue dissection at the tip of the malleolusin order to preserve the supply of blood via the "deltoid branch" (Mulfinger and Trueta 1970). In patients with impaired vascular supply to the foot because of poorly controlled diabetes or peripheral vascular disease, secondary anatomical reconstruction of the talus should rather not be attempted.…”

Subtalar Dislocation

“…The incidence of avascular necrosis is rather surprising: however, Mindell et al (1963) observed the phenomenon in two out of 10 patients. Studies of the blood supply to the talus (Haliburton et al 1958, Mulfinger & Trueta 1970, Petterson et al 1974 indicate that the body of the talus is supplied mainly by the tarsal canal artery. The latter may be damaged by the dislocation and, in the presence of fracture of the posterior tubercle-as seen in one of our patients in whom necrosis occurred-the vascularization will suffer additionally.…”