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removal of the extruded talus and placement of an external fixator.
5%
32/637
immediate tibiocalcaneal fusion.
1%
7/637
reimplantation of the talus, external fixation, and/or open reduction and internal fixation of the talar neck fracture.
91%
578/637
reimplantation followed by primary tibiotalar arthrodesis.
2%
10/637
Syme amputation.
0%
2/637
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The extruded talus should be placed in sterile bacitracin solution, irrigated thoroughly, gently debrided, and immediately replanted in the OR. Open reduction and internal fixation of the talar fracture may be attempted immediately depending on the soft-tissue envelope, or delayed after soft-tissue stabilization with an external fixator. A retrospective study of 19 patients with an extruded talus reported that 12 patients had no subsequent surgery after definitive fixation, 7 had subsequent procedures, and 2 patients developed infections that were treated successfully at an average of 42-month follow-up. Successful outcome in this series was attributed to multiple debridements, soft-tissue stabilization, and primary wound closure.
5.0
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