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Chirurgia Del Piede 2005 August;29(2):85-90

Copyright © 2005 EDIZIONI MINERVA MEDICA

language: Italian

Tibiotalar and subtalar arthrodesis in the sequelae of fractures of the talus

Pisani P. C.

Of the long-term complications of talus fractures, degenerative arthropathy, prevalently involving the subtalar joint, is the most frequent observation. Above all, however, following total fractures of corpus and neck, often comminuted and compound and at times complicated by bone ischaemia, secondary degenerative involvement may occur at the tibiotalar and talar calcaneal joints at the same time, albeit with a clearly lower frequency if compared with isolated involvement of the subtalar and tibiotalar joints. In cases of impairment of both joints, treatment favours contemporaneous arthrodesis, as the possibility of tibiotalar prosthesis and subtalar arthrodesis, or tibiocalcaneal arthrodesis is limited to rare cases, while resort to astragalectomy is quite exceptional. In our experience, the technique of contemporaneous arthrodesis reiterates access and procedures of tibiotalar arthrodesis by the transtibioperoneal route with apposition of the distal tract of the vascularised fibula, barring tiny variations as regards access and execution. Case series and results are reported.