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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2017, Number 1

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An Med Asoc Med Hosp ABC 2017; 62 (1)

Total talus replacement as a treatment of postraumatic avascular necrosis

Ávila SA, Myerson MS

Language: Spanish
References: 13
Page: 54-58
PDF size: 366.29 Kb.


ABSTRACT

The development of posttraumatic avascular necrosis of the talus is a condition that carries severe disability and is hard to treat surgically. Hindfoot reconstruction in a young patient after high impact trauma with talar avascular necrosis is a great challenge and there is controversy surrounding the long-term prognosis of the different treatment modalities. We report the case of a 28-year-old female with a one-year history of talar avascular necrosis after a motor vehicle accident. We performed a talectomy with the insertion of a custom-made total talus replacement created using the mirror image of a computed axial tomography scan of the contralateral ankle, as well as a percutaneous tendo Achilles lengthening. At the latest follow-up examination six months after surgery, the patient was walking without pain. Upon physical exploration, her ankle had 15o dorsiflexion and 20o plantar flexion. The chosen treatment aims to maintain a functional tibiotalar joint with adequate range of motion and free of residual pain. Although the long-term functional outcomes of the total talar prostheses are still unknown, we believe the procedure is a good option in the case of a selected group of young patients who wish to preserve mobility.


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