• Marco Breccia, Marco Peruzzi, Luana Cerbarano, and Marco Galli.
• Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Teaching Hospital "Agostino Gemelli", Rome 00168, Italy. Electronic address: m1breccia@gmail.com.
• Foot (Edinb). 2014 Jun 1; 24 (2): 89-93.

BackgroundOpen total talar extrusion is a severe, disabling ankle injuries. The most appropriate treatment (reimplantation versus talar body removal and tibiocalcaneal arthrodesis) is still a controversial challenge; outcomes and fearful potential complications are not predictable.ObjectiveTo report the case of an open ankle dislocation with talar extrusion, focusing on treatment modality and outcomes.MethodImmediate reduction, surgical debridement and external fixation were performed under antibiotic coverage. Wound closure was achieved with accurate debridement, postoperative strict clinical surveillance and meticulous handling of medications. The patient maintained external fixator for three weeks, then kept non-weight bearing with a cast for an additional four weeks.ResultsThe patient's wound healed with no complications. Full weight-bearing was gained at 12 weeks postoperation. At 18 months postoperatively, the patient did not develop any infection or a vascular necrosis, which are the major complications associated to talar extrusion.ConclusionsGood treatment procedure for a such severe open trauma, based on accurate debridement, wound care and stable temporary immobilization with external fixation allow reduction of infection risk and made preservation of extruded talus a successful option to preserve function and normal hindfoot anatomy at first instance. Talectomy should be considered as a salvage procedure.Copyright © 2014 Elsevier Ltd. All rights reserved.

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