B Rose1, C Southgate, L Louette. 1. Department of Orthopaedics, Queen Elizabeth The Queen Mother Hospital, East Kent Hospitals NHS Foundation Trust, St. Peters Road, Margate, Kent CT9 4AN, UK. barryrose@doctors.org.uk
Abstract
BACKGROUND: Bipartite talus is a rare condition of uncertain aetiology, with various treatment options described. METHODS: We report five symptomatic bipartite talus cases in four male patients warranting surgical management. All patients were reviewed by an independent assessor. RESULTS: The youngest patient presented with bilateral lesions without sub-talar arthrosis. He was treated twice by internal fixation with bone grafting. The left side failed to unite. The second patient presented with isolated sub-talar osteoarthritis. He underwent fragment excision and sub-talar arthrodesis with bone graft. The third patient presented aged 55 with severe hind-foot osteoarthritis, and underwent tibio-talar-calcaneal fusion. The final patient was treated with fragment excision and sub-talar arthrodesis. All patients reported symptom improvement or resolution post-operatively. Four cases showed evidence of radiographic union. CONCLUSIONS: We suggest a treatment rationale of fragment fusion if large enough, or excision if not, with associated limited fusion if the adjacent joints are markedly degenerate.
BACKGROUND: Bipartite talus is a rare condition of uncertain aetiology, with various treatment options described. METHODS: We report five symptomatic bipartite talus cases in four male patients warranting surgical management. All patients were reviewed by an independent assessor. RESULTS: The youngest patient presented with bilateral lesions without sub-talar arthrosis. He was treated twice by internal fixation with bone grafting. The left side failed to unite. The second patient presented with isolated sub-talar osteoarthritis. He underwent fragment excision and sub-talar arthrodesis with bone graft. The third patient presented aged 55 with severe hind-foot osteoarthritis, and underwent tibio-talar-calcaneal fusion. The final patient was treated with fragment excision and sub-talar arthrodesis. All patients reported symptom improvement or resolution post-operatively. Four cases showed evidence of radiographic union. CONCLUSIONS: We suggest a treatment rationale of fragment fusion if large enough, or excision if not, with associated limited fusion if the adjacent joints are markedly degenerate.
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