Journal of Foot and Ankle Surgery (Asia Pacific)

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VOLUME 5 , ISSUE 1 ( June, 2018 ) > List of Articles

ORIGINAL ARTICLE

Extruded Talus Injuries: A Cross-sectional Survey of Indian Orthopedic Surgeons

Sharad Prabhakar, Sameer Aggarwal, Devendra K Chouhan

Keywords : Extruded talus, Missing talus, Survey, Talar dislocation, Talar extrusion, Talus

Citation Information : Prabhakar S, Aggarwal S, Chouhan DK. Extruded Talus Injuries: A Cross-sectional Survey of Indian Orthopedic Surgeons. J Foot Ankle Surg Asia-Pacific 2018; 5 (1):1-4.

DOI: 10.5005/jp-journals-10040-1080

License: CC BY-NC 4.0

Published Online: 01-03-2017

Copyright Statement:  Copyright © 2018; The Author(s).


Abstract

Introduction: Management of extruded talus (ET) injuries poses a dilemma, owing to its rarity as well as the paucity and diversity of the published literature. Materials and methods: We designed an eight-item questionnaire-based survey, which was administered to Indian orthopedic surgeons. Results: A total of 379 participants completed the survey, 265 (69.9%) reported having seen or treated a case of ET; 172 participants reported following up their case for >1 year. Of these, 33 cases (8.7%) had a well-retained talus without any evidence of avascular necrosis (AVN), arthrosis, or infection; 104 (27.4%) cases had AVN with or without infection; 42 (11.1%) cases developed ankle arthrosis and the talus was not retained and arthrodesis done in 12 (3.1%) cases. A total of 235 (62%) participants chose AVN as the most feared complication, followed by infection (20.3%, n = 77) and arthroses (7.4%, n = 28); 359 (94.7%) participants preferred primary repositioning of ET; 320 (84.4%) participants were not aware of any studies reporting long-term outcomes of these injuries. Conclusion: Most Indian surgeons prefer primary repositioning of ET to talectomy and arthrodesis. Avascular necrosis remains the major concern after repositioning. Awareness on long-term outcomes of these injuries is lacking, and more studies reporting long-term outcomes are needed.


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  1. Coltart WD. Aviator's astragalus. J Bone Joint Surg Br 1952 Nov;34:545-566.
  2. Leitner B. The mechanism of total dislocation of the talus. J Bone Joint Surg Am 1955 Jan;37:89-95.
  3. Detenbeck LC, Kelly PJ. Total dislocation of the talus. J Bone Joint Surg Am 1969 Mar;51(2):283-288.
  4. Apostle KL, Umran T, Penner MJ. Reimplantation of a totally extruded talus: a case report. J Bone Joint Surg Am 2010 Jul 7;92(7):1661-1665.
  5. Gulan G, Sestan B, Jotanoviæ Z, Madareviæ T, Mikaceviæ M, Ravliæ-Gulan J, Rapan S, Jovanoviæ S. Open total talar dislocation with extrusion (missing talus). Coll Antropol 2009 Jun;33(2):669-672.
  6. Vaienti L, Maggi F, Gazzola R, Lanzani E. Therapeutic management of complicated talar extrusion: literature review and case report. J Orthop Traumatol 2011 Mar;12(1):61-64.
  7. Burston JL, Isenegger P, Zellweger R. Open total talus dislocation: clinical and functional outcomes: a case series. J Trauma 2010 Jun;68(6):1453-1458.
  8. Mohindra M, Gogna P, Thora A, Tiwari A, Singla R, Mahindra P. Early reimplantation for open total talar extrusion. J Orthop Surg (Hong Kong) 2014 Dec;22(3):304-308.
  9. Smith CS, Nork SE, Sangeorzan BJ. The extruded talus: results of reimplantation. J Bone Joint Surg Am 2006 Nov;88(11): 2418-2424.
  10. Weston JT, Liu X, Wandtke ME, Liu J, Ebraheim NE. A systematic review of total dislocation of the talus. Orthop Surg 2015 May;7(2):97-101.
  11. Burston JL, Brankov B, Zellweger R. Reimplantation of a completely extruded talus 8 days following injury: a case report. J Foot Ankle Surg 2011 Jan-Feb;50(1):104-107.
  12. Lee HS, Chung HW, Suh JS. Total talar extrusion without soft tissue attachments. Clin Orthop Surg 2014 Jun;6(2):236-241.
  13. Vaienti L, Maggi F, Gazzola R, Lanzani E. Therapeutic management of complicated talar extrusion: literature review and case report. J Orthop Traumatol 2011 Mar;12(1):61-64.
  14. Dhillon MS, Sharma S. Subtalar dislocations, total talar dislocations and the extruded talus: a polynymous injury or separate entities? J Foot Ankle Surg (Asia Pacific) 2015; 2(1):v-vi.
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