Marengo Asia Hospital (Formerly Sunshine Global Hospital), Vadodaranr. Shreyas Vidhyalay, behind ICICI Bank, Lalbaug, Manjalpur, Vadodara, Gujarat 390004 / Marengo Asia Hospital (Formerly Sunshine Global Hospital), SuratDumas Rd, beside Big Bazar, Piplod, Surat, Gujarat 395007
Total Talus Replacement
When Total Talus Replacement Is the Wrong Choice
A cautionary case — a malunited talus dislocation where total talus replacement could not be reduced despite extensive releases, ultimately salvaged by tibiocalcaneal fusion.
Patient Age
26 Years
MECHANISM
Road traffic accident
PRESENTATION
2 Years Post-Injury with Malunion
APPROACH
Attempted Replacement, Salvage Tibiocalcaneal Fusion
01
Clinical Rationale
Despite Achilles lengthening, distraction and extensive releases, even the smallest implant could not be reduced into a joint stiffened by two years of malunion and set arthritis. The honest outcome was to abandon replacement and salvage the ankle with fusion.
02
Surgical Approach
Total talus replacement was attempted but, after a 90-minute struggle, even the smallest implant could not be reduced into the joint despite Achilles lengthening, Hintermann distraction and capsular releases. The implant was extracted and the ankle salvaged with a Bamboo-hut tibiocalcaneal fusion.
02
Imaging & Progression
Pre-operative imaging, intra-operative views and post-operative results. Each slot maps to a CMS image field — drop in the matching consented file from the case folder.
#1
Total talus replacement is not an easy surgery and demands careful case selection.
#2
Post-traumatic cases require extensive tissue releases and balancing before any implant will reduce.
#3
Many such cases justify a staged surgical approach rather than a single sitting.
#4
Set arthritis of the ankle is a contraindication to total talus replacement.
04
Clinical Care Points
RIGHT SIDE
- i) Attempted TTR — could not reduce implant
ii) Achilles lengthening + capsular releases failed
iii) Implant extraction
iv) Bamboo-hut tibiocalcaneal fusion salvage
LEFT SIDE
-
| 35+ YEARS OF TRUST, CARE & EXCELLENCE
When Total Talus Replacement Is the Wrong Choice
A cautionary case — a malunited talus dislocation where total talus replacement could not be reduced despite extensive releases, ultimately salvaged by tibiocalcaneal fusion.
A 26-year-old man presented two years after a fracture-dislocation of the talus sustained in a road-traffic accident. The injury had progressed to malunion, arthritis, avascular necrosis and a fixed equinus deformity. Total talus replacement was planned in an attempt to restore height and movement, but the chronic post-traumatic anatomy proved far less accommodating than expected.
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