Abstract
Introduction: If you loose the talus, especially in infection cases, you have a problem. Literature says, that in a lot of cases you should amputate. We analysed 17 cases, being transferred to our hospital with a non-union an 12 own cases. The question was: What ca you do, to get an acceptable result. An analysis of the mistakes was tried to achieve.
Material and Method: 29 cases were analysed in this retrospective study. In 27 cases an infection situation was found. In 2 cases a vascular disturbance of the talus, avascular necrosis, was found. We analysed the stabilization method, the length of non weight bearing and the personal compliance of the patient. We found patients being stabilized with a nail, an external fixator of AO or Ilisarov Fixator.
Results: In about 68% of the non-union cases too early weight bearing therapy according to mobilization of the joints occurred. In 32% a cancellous bone graft didn’t take place. Shortening of the leg > 4 cm happened in 69%.
Discussion: The problem of stabilization of this anatomical area is well known. The anatomy itself brings problems. But the surgeons opinion, to make a very early functional treatment possible, is contraproductive in these cases. Leave the implant much longer than you would think, start weight bearing only after 6 weeks and you can get reasonable results. Callus distraction solves the problem of leg length discrepany. During that time, lasting longer than the arthrodesis, the bone heals. Leave the fixator for the whole time in situ and you will get an acceptable result for the patient. More than that, make an additional arthrodesis between the tibia and the Naviculare bone. Our own results demonstrate a success rate of 80% in these desperate cases.
The abstracts were prepared by editorial secretary, Mrs K. Papastefanou. Correspondence should be addressed to Professor K.N. Malizos, Department of Orthopaedic Surgery, School of Medicine, University of Thessalia, Larissa, 41222 GREECE
