Reconstructive surgery for complete talus extrusion using the sandwich block arthrodesis: a report of 2 cases.

Abstract

Total extrusion of the talus is a rare and severe injury of the foot. If the talus is viable and can be repositioned, the outcome is unpredictable and mainly depends on whether infection and/or avascular necrosis ensues. If the talus is actually missing, the surgeon is faced with extensive bone loss and destruction of the ankle. In this report, we present 2 cases of total talus extrusion treated with the sandwich block tibiocalcaneal arthrodesis with structural autografts harvested from iliac crest. The surgical technique is reviewed in detail, and its application in 2 male patients who had a complete talus fracture-dislocation and a dislocation, respectively, is described. Follow-up after 18 years and 1 year, respectively, showed favorable clinical outcomes and only minor restrictions in daily activities. In light of these case reports, we believe that the sandwich block arthrodesis offers a useful alternative for the treatment of these serious lower extremity injuries.