Anatomical reconstruction of malunited talus fractures: A prospective study of 10 patients followed for 4 years

Background Malunions or nonunions after displaced talar fractures cause significant disability. Salvage procedures such as corrective arthrodesis do not restore normal foot function.Methods Between 1994 and 2002, we treated 10 patients (aged 15–50 years) who had painful malunions with secondary anatomical reconstruction, at a mean of 1 year after sustaining displaced fractures of the talar body or neck. 5 patients were classified as type I (malunion and/or residual joint displacement), 2 as type II (nonunion with displacement) and 3 as type III (malunion with partial avascular necrosis, AVN). Correction was by an osteotomy through the malunited fracture or removal of the pseudarthrosis. Internal fixation was achieved with screws and additional bone grafting if necessary.Results No wound healing problems or infections were seen. Solid union was obtained without redislocation in all cases, with no signs of development or progression of AVN. At a mean of 4 (1–8) years after reconstruction, all patients were ...