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At least 19 recordsLinked to original sources
PubMed1992

Open total dislocation of the talus with extrusion (missing talus): report of two cases.

Two different methods of treatment for open dislocation of the extruded talus without soft tissue attachments (missing talus) were examined. In case 1, a 20-year-old man sustained an open total dislocation of the talus due to a motorcycle accident. The missing talus was found within 3 hr and replaced after thorough washing and debridement. Weightbearing was permitted at 20 weeks; however, the density of the talar body increased in the x-ray and nonweightbearing status was resumed. Reexamination at 2 1/2 years revealed that there was joint space narrowing on the x-ray and decreased pain with ambulation; the patient had returned to his job. In case 2, a 26-year-old man sustained an open total dislocation of the talus with a severe crush wound and impaired circulation to the foot. After thorough washing and debridement of the wound, the calcaneus and distal end of the tibia were aligned. The missing talus was found 3 days later, but not replaced. Weightbearing was allowed on the affected foot at 2 months; however, the patient felt pain at the joint surfaces and arthrodesis was consequently performed. At 2 1/2 years, the patient had a 4.0-cm leg length discrepancy in the involved extremity, but felt no pain when walking. Although reduction of the talus is ideal to preserve function and length of the extremity, several complications can occur. A review of literature on open total dislocation of the talus with extrusion was performed.

Adult↗
PubMed1978

Surgical excision of an os talus secundarius: a case report.

Os talus secundarius is a relatively rare developmental abnormality of the talus; it is characterized by its location on the lateral aspect of the talus. This secondarily developed talus dramatically limits the range of motion of the ankle and subtalar joints. Differential diagnosis between talus secundarius and talus accessorius can usually be made radiographically. Talus secundarius secures itself to the lateral body of the talus by either a synchondrosis or synostosis and usually forms a set of articulations with the fibula, the superior lateral surface of the calcaneus, and a portion of the body of the true talus. Talus accessorius, however, is usually on the medial side of the talus and may form in the deltoid ligament. Talus accessorius is similar to the intercalary sesamoid bone between the external malleolus and the talus.

Adult↗
PubMed1979

Gross and histological abnormalities of the talus in congenital club foot.

Gross and histological abnormalities were demonstrated in a club-foot talus from a boy with multiple congenital anomalies who died when he was nine days old. Both tali were studied, the one from the club foot and the one from the normal foot. The gross anomalies involved the smaller size of the club-foot talus and the increased medial deviation of a stunted, misshapen head and neck region. Serial histological sections of both tali allowed for a three-dimensional geometric appreciation of both bones and an assessment of the nature and extent of histological and cytological features. The ossification center of the club-foot talus was absolutely and relatively smaller than that of the normal talus. It was eccentrically positioned, being more lateral and anterior than that of the normal talus. The marked histological abnormalities seen in the head and neck region of the club-foot talus involved extensive breaching of the endochondral sequence by vessels. The posterior aspect of the endochondral sequence and ossification center was normal. The extra-osseous and intra-osseous blood supply of the two tali was normal with the exception of the increased and irregular breaching of the endochondral sequence in the club-foot talus. This study demonstrates histological abnormalities in the head and neck region of the club-foot talus, which was most abnormal grossly. The eccentric position of the secondary ossification center as well as its related vascular abnormalities do not support a theory of developmental arrest of the talus but appear sufficiently abnormal to support the theory of a primary defect in the cartilage anlage. Clinically, one must bear in mind that early open reduction of the talocalcaneal navicular joint in a foot such as this would have served to reposition the navicular onto a talus that still was structurally abnormal.

Clubfoot↗
PubMed1992

Functional, radiographic, and histologic assessment of healing of autogenous osteochondral grafts and full-thickness cartilage defects in the talus of dogs.

A circular (5.5 mm diameter) full-thickness cartilage defect was created on the medial ridge of the talus in 12 skeletally mature dogs. In 6 dogs, the articular surface of the lesion was repaired, using an osteochondral graft obtained from the ipsilateral manus. The graft (digit I, first phalanx, distal articular surface and diaphysis) was contoured to obtain a press fit in the drilled talar recipient site. In 6 dogs, the lesion was not treated and healed by fibrous tissue replacement. Functional assessment (lameness, hock range of motion, joint stability, joint crepitus, and mid-femoral muscle circumference) was completed before surgery and at postoperative weeks 2 through 20. Radiographic assessment (periarticular soft tissue width, joint space width, osteophyte formation, and graft incorporation) was completed before surgery and at postoperative weeks 0, 6, 12, and 20. To facilitate histologic assessment, tissues were stained with toluidine blue and H&E. Histologic assessment of the articular surface on the surgically treated talus, ipsilateral tibia, and contralateral talus was completed, using a modification of the Mankin grading system. Subchondral bone was examined to assess graft viability and incorporation. Analysis of the ordinal data was completed, using a Mann-Whitney rank sum test. All dogs were fully weight bearing by postoperative week 7. Dogs without grafts had significantly (P = 0.036) better clinical function at postoperative week 6. Significant difference in functional assessment was not evident at postoperative week 20. Immediate postoperative radiographic assessment revealed significant (P = 0.005) difference between nongrafted and grafted groups. Significant difference was not observed at postoperative week 6, 12, or 20. All grafts appeared radiographically incorporated by postoperative week 12. All grafts restored joint surface congruity, whereas 3 of 6 nongrafted lesions had poor articular congruity. Of 6 grafts, 4 partially retained normal hyaline cartilage, resulting in significantly (P = 0.014) lower Mankin grades. Significant histologic differences between groups were not apparent when the apposing tibia and control talus were examined. Talar reconstruction by use of a phalangeal osteochondral graft is a viable surgical procedure. These data indicate that normal articular and subchondral architecture are more closely approximated by osteochondral reconstruction than by fibrous tissue repair.

Animals↗
PubMedDate not supplied

Complete posterior dislocation of the talus. Case report and discussion.

Complete dislocation of the talus is an injury that is produced by a great magnitude of force, producing severe soft tissue injury, frequently vascular compromise, often with subsequent avascular necrosis. Complete posterior dislocation of the talus seems not to have been reported previously. The treatment in a 39-year-old man was designed on the basis of experience with antero-medial dislocation. Treatment ranges from attempted anatomical reduction to early arthrodesis of one or all of the articulations of the talus, with and without talectomy. No one method has shown to be superior to the others. Oen reduction is often unsuccessful, probably because of ankle malalignment. Avascular necrosis of the talus without collapse is not necessarily painful. In the present case talectomy and tibio-calcaneal fusion was performed one year after injury. The symptomatic results were good. Accurate anatomical reduction should be the aim of initial therapy. Definitive therapy can be designed to fit the requirements of the individual case.

Accidents, Traffic↗
PubMedDate not supplied

Injuries of the talus and its joints.

To understand the mechanism of injury and classify fractures of the talus requires knowledge of the anatomy of the hindfoot, its function and the nature of the traumatic forces. The talus has an irregular shape with articular surfaces for tibia, fibula, calcaneus and navicular. It functions as a complex universal joint between the leg and foot created by the ankle, sub-talar and midtarsal joints. Injury may disturb function and create serious disability. As in the femoral head, osteonecrosis is a serious problem after injury to the talus. The reason for this lies in a peculiar distribution of the arterial circulation which exposes it to some injuries, but not to others. To understand the mechanism of injury is to be better prepared to properly treat these injuries and to more accurately predict their consequences. Injury occurs as motion caused by an extrinsic force is applied to the part, and when the motion is forceful enough to overcome resistance. For the talus and its joints the mechanisms of injury are: extension, flexion, inversion, eversion, and compression. Rotation, medial and lateral, may be important in the production of fractures of the talar trochlea. Combinations of these mechanisms cause complex injuries.

Ankle Injuries↗
PubMed1976

The estimation of sex on the basis of the talus and calcaneus.

The present report records and describes sexual dimorphism of the talus and calcaneus in American Blacks and Whites from the Terry Collection housed in the Smithsonian Institution, Washington, D.C. The greater amount of sexual dimorphism was observed in the talus, where 81 percent of the study sample could be accurately sexed. Four discriminant functions based on measurements from the talus and/or the calcaneus allowed sexing 79 to 89% of the study sample accurately. The techniques developed were then applied to two North American Indian samples, and sex of the individuals in these samples was assessed with the same degree of accuracy.

Black People↗
PubMed1977

[The importance of the radiological angle between talus and calcaneus in patients with congenital clubfoot (author's transl)].

A reduction of the angle between the longitudinal axes of talus and calcaneus in the lateral X-ray view of a clubfoot is a sign of persistent supination of the subtalar joint and not due to anatomical changes of the bone. Correction of this deformity by closed manipulation produces a normal angle between talus and calcaneus. The angle between talus and calcaneus can thus be used as a guide for adequate correction of the subtalar deformity.

Anthropometry↗
PubMed1977

Fractures of the neck of the talus.

One hundred and twenty-three patients with fracture of the neck of the talus were followed up over an average of 22 months. Ffity-four fractures were undisplaced, 53 associated with subtaler dislocation, and 16 associated with dislocation of the talus in both ankle joint and subtalar joint. Of the total 123 patients, 21% (26/123) developed avascular necrosis, 31% (38/123) developed talo-crural and 47% (58/123) subtalar osteoarthrosis. Fifteen per cent (18/123) of the fractures united with considerable deformity, and four per cent (5/123) exhibited non-union of the neck. Out of 63 patients with isolated fracture of the neck of the talus, 65% (41/63) reported moderate or severe complaints, and 52% (33/63) complained of functional disability often resulting in a change to lighter work. Even among the 54 undisplaced cases there were unexpected numbers of late sequelae, such as osteoarthrosis, subjective complaints and disablement.

Adolescent↗
PubMed1975

Congenital paralytic vertical talus. An anatomical study.

Dissections of the feet of a three-month-old infant with paralytic congenital vertical talus secondary to lumbar myelomeningocele were compared with a dissection of a normal foot. The major differences appeared to be absence of the plantar intrinsic muscles and dorsal dislocation of the talonavicular joint. It is postulated that the pathological process begins as a failure of the intrinsic muscles to oppose the unbalanced, active dorsiflexion forces of the anterior crural muscles. This imbalance then allows disruption of the talonavicular joint, mechanically the least stable joint in the mid-part of the foot. All dorsiflexion forces acting on the ankle then become ineffective and plantar flexion forces serve only to pull the calcaneus and talus into equinus, causing a "vertical" talus. Treatment must be directed at reducing the talonavicular dislocation, correcting the equinus deformity of the hind part of the foot, and substituting for the undeveloped plantar intrinsic muscles.

Flatfoot↗
PubMed1992

[Long-term results of talus fractures].

In a retrospective study we analysed 29 operative treated fractures of the Talus. The classification of Marti and Weber has been used in this study. The incidence of necrosis was 17% of the group III and IV and that one of arthritis 27%. There was no infection in our series. We doubt that a longterm non weight-bearing with a caliper brace has an effect on the outcome of a necrosis of the Talus. The evidence of the Hawkins' sign on the ap-radiograph at 6-8 weeks is a good and simple parameter of the vitality of the Talus.

Adolescent↗
PubMedDate not supplied

Congenital vertical talus and its familial occurrence: an analysis of 36 patients.

Thirty-six patients (57 feet) showing congenital vertical talus were treated at the St. Louis Unit of the Shriners Hospital between 1958 and 1978. A high incidence of congenital hip dislocatiom, arthrogryposis, congenital hypoplasia of tibia and CNA disorders was noted as associated abnormalities. These patients are classified in 3 groups: (I) primary isolated form (16 patients); (II) associated form without neurological deficit (12 patients); (III) associated form with neurological deficit (8 patients). Fifty per cent of the patients with primary isolated form had positive family history of foot deformities in their first degree relatives. Familial incidence of congenital vertical talus was observed in 2 families studied. Genetic factors may play an important role in the etiology of the primary isolated form of congenital vertical talus. The current treatment is a one-stage open reduction of the talonavicular dislocation, combined with a posterior release. A subtalar bone block is often imperative to maintain correction. Cast correction alone has never succeeded as the definitive treatment of this condition.

Female↗
PubMedDate not supplied

Conservative management of pes valgus with plantar flexed talus, flexible.

The type of flat foot that we have called pes valgus with plantar flexed talus, flexible, was treated in children with the Helfet heel seat or the UCBL shoe insert. In follow-up examination of 71 cases for periods longer than one year, 79 per cent of the patients showed that the UCBL shoe insert and the Helfet heel seat improved the clinical and roentgenographic appearance of the foot. The Helfet heel seat is recommended in cases where the plantar flexion angle of the talus is 35 to 45 degrees and the UCBL shoe insert in those cases of plantar flexion of the talus greater than 45 degrees.

Adolescent↗
PubMed1979

Tuberculous osteitis of the talus.

A case of tuberculous osteitis of the talus in a 6-year-old white male is reported. Osteitis of the talus is uncommon and tuberculous disease of this bone is now rare. There was a delay of 5 weeks between presentation and final diagnosis and the reasons for this delay are discussed. Further investigation showed the presence of tuberculosis of the fifth lumbar vertebra and of the left kidney. With prompt chemotherapy and early surgery, the long term results of this once crippling disease are now excellent.

Child↗