Astragalectomy

functional and radiological evaluation

Abstract

Functional (AOFAS score) and radiological (X-rays) of five talectomies in four patients with different etiologies: cases 1 and 4, septic osteonecrosis secondary to open fractures of the talus; case 2, osteonecrosis associated with rigid equinovarus hindfoot, sequelae of severe open tibia fracture, and case 3, neurological rigid equinovarus hindfoot, bilateral. All patients were men, with an average age of 32.5 years (range 19-56). At 38-month follow-up (range 15-84) there were no signs of osteoarthritis, or mild signs and absence of pain. AOFAS score of 81.4 points (preoperative score 17), a length discrepancy of lower limb <2cm, and a range of flexion and extension of 18° on average (variance between 10° and 45°). Two mild varus hindfoot and three asymptomatic and neutral alignments. There is a good correlation among the patient’s symptoms, proper alignment and few imaging signs of osteoarthritis in the ankle or other joints in the foot. If treatment with an arthrodesis or an ankle replacement is not possible, the talectomy is an acceptable salvage procedure for patients with severe deformities, bone stock deficiency and recalcitrant infections in the ankle.