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Epidemiology of talus fractures in Finland: a nationwide register study from 1997 to 2020.

BMC Musculoskelet Disord

December 2024

Unit of Musculoskeletal Surgery, Department of Orthopedics and Traumatology, Tampere University Hospital, Tampere, Finland.

Background: The aim of this study was to estimate the nationwide incidence of talus fractures (per 100 000 person-years) and to determine the incidence of operative treatment in the Finnish population.

Methods: Based on Finnish Care Register for Health Care data, all patients 18 years and older admitted to hospital with talar fractures between 1997 and 2020 were included.

Results: During the 24-year study period, 5247 patients with primary or secondary diagnoses of talar fracture were identified.

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Recurrent Medial Malleolar Stress Fracture: A Case Report and Discussion of Risk Factors.

Cureus

October 2024

Orthopedics and Traumatology, Unidade Local de Saúde de Barcelos/Esposende, Barcelos, PRT.

Stress fractures of the medial malleolus are uncommon and considered high-risk due to potential complications such as progression to complete fracture, delayed union, nonunion, and chronic pain. Identified risk factors include varus alignment of the lower limb, chronic anteromedial impingement, excessive pronation/supination, broad talar neck, and ankle instability. To our knowledge, no reports of recurrence after surgical treatment have been reported.

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Total talus replacement (TTR) is a viable surgical option in the setting of talar avascular necrosis and collapse, as well as a revision option for failed total ankle arthroplasty with talar implant subsidence. The purpose of the present study was to compare the clinical and radiographic outcomes following isolated TTR and TTR combined with total ankle arthroplasty or hindfoot arthrodesis. Patients who underwent TTR were retrospectively reviewed, as a multicenter consecutive case series.

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New technologies in additive manufacturing and patient-specific CT-based custom implant designs make it possible for previously unimaginable salvage and limb-sparing operations a practical reality. This study presents the design and fabrication of a lattice-structured implant for talus replacement surgery. Our primary case involved a young adult patient who had sustained severe damage to the talus, resulting in avascular necrosis and subsequent bone collapse.

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Article Synopsis
  • The study focuses on the surgical outcomes of custom 3D-printed total talus replacement (TTR) and combined total ankle total talus replacement (TATTR) in patients suffering from talus collapse and peri-talar arthritis, with a follow-up of around 22 months.
  • A total of 38 patients were examined, with findings indicating that 18.4% required secondary surgery, and 7.9% had their implants removed, while significant improvements were noted in talocalcaneal height and physical function post-surgery.
  • Overall, the results suggest that TTR and TATTR can significantly enhance foot and ankle alignment and patient activity levels, although initial pain relief diminished over time.
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