This is a plain-English translation of the academic paper above, prepared for patients, referring clinicians, and other non-specialist readers. It preserves the structure of the original paper while removing technical jargon. For the full clinical paper, follow the PubMed or DOI links.
Background
How patients fare in the medium term — pain, walking, return to normal life — after suffering a rare and severe ankle injury called talar extrusion, where the talus (the keystone bone of the ankle) is forced partly or completely out of the foot through the skin. We followed twelve patients treated at a major trauma centre.
Rationale
Talar extrusion is a high-energy injury (typically a serious car accident or fall from height) and was historically treated by removing the bone and fusing the joint. More recently, surgeons have moved towards cleaning the extruded bone and putting it back — reimplantation — in the hope of preserving more function. The evidence base for this newer approach is small, mostly individual case reports.
Results
All twelve patients underwent successful reimplantation of the talus. Patients with partial extrusions and associated fractures tended to do better in walking, pain and social-life scores than patients whose ligaments had failed completely and the bone had come out cleanly. One patient developed avascular necrosis (loss of blood supply to the bone), three developed infection, and one eventually required below-knee amputation. Most retained their reimplanted talus and avoided fusion in the medium term.
Implications
Talar extrusion remains a serious injury with persistent deficits at mid-term follow-up — patients should be counselled honestly that they will likely have lasting pain and walking limitations. Even so, our results support reimplantation, rather than removal of the bone, as a reasonable treatment approach in most cases. Larger multi-centre studies are still needed to refine which patients benefit most.
Source: Jha S, Atkinson K, McFegan MR, Patel A, Vris A, Heidari N, Parker L, Jeyaseelan LA, Malagelada F. Assessment of Midterm Functional Outcomes Following Talar Extrusion Injuries. Foot & Ankle Orthopaedics 2022. doi:10.1177/2473011421s00266
Read full open-access paper (PDF) → Read original (DOI) → ← Back to research library