Early Reimplantation for Open Total Talar Extrusion

Purpose. To review outcome of early reimplantation for open total talar extrusion in 7 patients. Methods. Medical records of 5 men and 2 women aged 19 to 53 years who underwent reimplantation for open total talar extrusion within 6 hours after road traffic accident (n= 6) or industrial injury (n=1)...

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Main Authors: Mukul Mohindra, Paritosh Gogna, Ankit Thora, Anurag Tiwari, Rohit Singla, Pankaj Mahindra
Format: Article
Language:English
Published: SAGE Publishing 2014-12-01
Series:Journal of Orthopaedic Surgery
Online Access:https://doi.org/10.1177/230949901402200307
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author Mukul Mohindra
Paritosh Gogna
Ankit Thora
Anurag Tiwari
Rohit Singla
Pankaj Mahindra
author_facet Mukul Mohindra
Paritosh Gogna
Ankit Thora
Anurag Tiwari
Rohit Singla
Pankaj Mahindra
author_sort Mukul Mohindra
collection DOAJ
description Purpose. To review outcome of early reimplantation for open total talar extrusion in 7 patients. Methods. Medical records of 5 men and 2 women aged 19 to 53 years who underwent reimplantation for open total talar extrusion within 6 hours after road traffic accident (n= 6) or industrial injury (n=1) were reviewed. The talus was first irrigated with 9 to 10 litres of saline solution, followed by 10% povidone iodine. It was then reduced after thorough debridement and fixed with tension band wiring or external fixation. Ankle mobilisation exercises were started at week 6 and full weight bearing at week 14. Outcome was assessed using the American Foot And Ankle Society score. Results. After a mean follow-up of 31.9 (range, 24–46) months, the mean American Foot and Ankle Society score was 81, and the mean dorsiflexion-plantar flexion arc was 36.9° (range, 25°–45°). All patients were able to walk with a balanced, unaided gait with mild-to-moderate pain (n=3) or pain-free (n=4). No patient developed deep infection or instability. Three patients developed avascular necrosis of the talus; restriction of motion was moderate at the ankle joint and severe at the subtalar joint. None of these 3 patients opted for revision surgery, as the pain was tolerable and did not limit their daily activities, but their condition was expected to deteriorate with time. Conclusion. Early reimplantation is recommended for open total talar extrusion, as it restores (to some extent) hind foot mechanics, heel height, and bone stock for activities of daily living and future reconstructive options.
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spelling doaj.art-20e56c0ff3254f248574f6d15fb63f0c2022-12-22T00:20:56ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902014-12-012210.1177/230949901402200307Early Reimplantation for Open Total Talar ExtrusionMukul Mohindra0Paritosh Gogna1Ankit Thora2Anurag Tiwari3Rohit Singla4Pankaj Mahindra5 Department of Orthopaedics, Maulana Azad Medical College and associated Hospitals, New Delhi, India Department of Orthopaedics and Rehabilitation, Pt B.D Sharma Post graduate Institute of Medical Sciences, Rohtak, Haryana, India Department of Orthopaedics, Maulana Azad Medical College and associated Hospitals, New Delhi, India Department of Orthopaedics, Maulana Azad Medical College and associated Hospitals, New Delhi, India Department of Orthopaedics and Rehabilitation, Pt B.D Sharma Post graduate Institute of Medical Sciences, Rohtak, Haryana, India Department of Orthopaedics, Dayanand Medical College and Hospital, Ludhiana, Punjab, IndiaPurpose. To review outcome of early reimplantation for open total talar extrusion in 7 patients. Methods. Medical records of 5 men and 2 women aged 19 to 53 years who underwent reimplantation for open total talar extrusion within 6 hours after road traffic accident (n= 6) or industrial injury (n=1) were reviewed. The talus was first irrigated with 9 to 10 litres of saline solution, followed by 10% povidone iodine. It was then reduced after thorough debridement and fixed with tension band wiring or external fixation. Ankle mobilisation exercises were started at week 6 and full weight bearing at week 14. Outcome was assessed using the American Foot And Ankle Society score. Results. After a mean follow-up of 31.9 (range, 24–46) months, the mean American Foot and Ankle Society score was 81, and the mean dorsiflexion-plantar flexion arc was 36.9° (range, 25°–45°). All patients were able to walk with a balanced, unaided gait with mild-to-moderate pain (n=3) or pain-free (n=4). No patient developed deep infection or instability. Three patients developed avascular necrosis of the talus; restriction of motion was moderate at the ankle joint and severe at the subtalar joint. None of these 3 patients opted for revision surgery, as the pain was tolerable and did not limit their daily activities, but their condition was expected to deteriorate with time. Conclusion. Early reimplantation is recommended for open total talar extrusion, as it restores (to some extent) hind foot mechanics, heel height, and bone stock for activities of daily living and future reconstructive options.https://doi.org/10.1177/230949901402200307
spellingShingle Mukul Mohindra
Paritosh Gogna
Ankit Thora
Anurag Tiwari
Rohit Singla
Pankaj Mahindra
Early Reimplantation for Open Total Talar Extrusion
Journal of Orthopaedic Surgery
title Early Reimplantation for Open Total Talar Extrusion
title_full Early Reimplantation for Open Total Talar Extrusion
title_fullStr Early Reimplantation for Open Total Talar Extrusion
title_full_unstemmed Early Reimplantation for Open Total Talar Extrusion
title_short Early Reimplantation for Open Total Talar Extrusion
title_sort early reimplantation for open total talar extrusion
url https://doi.org/10.1177/230949901402200307
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