Hazards of talar fusion surgery

Generally, talar fusion surgery is used to treat tibiotalar arthritis, which is the main cause of the need for treatment. The requirements for talar fusion surgery are relatively high, so patients need to go to a large regular hospital for the procedure. If the talar fusion surgery is not done well, it will cause some harm to the patient, such as postoperative pain.

Talar fusion surgery is often used in cases of severe tibiotalar arthritis or talar necrosis that affects normal walking. After the talar fusion surgery, the ankle joint cannot move normally, which affects squatting and makes it difficult to complete movements such as deep squats. However, if severe talar necrosis or tibiotalar arthritis is not treated with fusion surgery, walking function will be significantly affected. The technical requirements for talar fusion surgery are relatively high, and if not performed properly, there will be many complications. If this type of surgery is required, it is best to go to the orthopedics department of a municipal first-level hospital for treatment.

Surgical procedures

Hoke-Kite method:

1. The incision is located between the peroneus longus tendon and the peroneus tertius muscle, starting from the posterior and inferior part of the lateral side of the talar head to the bottom of the end of the fibula. The adipose tissue in the talar sinus was dissected and the soft tissue overlying the talar neck was removed. Use a knife to cut the talonavicular ligament from the outside to the inside of the talar head and separate the talar head from the navicular bone. Then use a bone knife to remove part of the inferior articular surface of the talar body and the adjacent calcaneal articular surface. The talar head, neck and body are separated and removed after removing the attached soft tissue. The articular surface of the scaphoid and the small articular surface above the calcaneus are removed with a small osteotome.

2. Correct lateral and rotational deformities of the foot, adjust the calcaneus to achieve satisfactory alignment, and shift the foot posteriorly if necessary. The decartilaged talar head is re-implanted between the talar body and the navicular bone. The placement of the talar head is determined according to the type and degree of deformity, so that the foot is slightly dorsiflexed. Finally, use Steinmann wires, U-shaped nails or screws to maintain the position. Immobilize with a short-leg plaster cast.

Postoperative care

Within 48 to 72 hours after total talar arthrodesis, the plaster is suspended on a traction frame above the head. The stitches are removed after 10 to 14 days, and then the plaster is replaced. The patient can walk with the help of crutches without bearing weight. The plaster fixation time should not be less than 4 weeks, after which the plaster is removed and an X-ray examination is taken. The weight-bearing short-leg walking cast should be fixed until 12 weeks after surgery, at which time X-rays and clinical manifestations indicate that the bone has healed firmly.