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Authors report on the substitution of in consequence of complete talus luxation, missing talus. It succeeded with the transplantation of a free vascular pedicled bone block, gained from the crista ilei to retain the length of the extremity and to secure the gait of the patient without aid, finally to make the return to the former active life possible. The use of the method in similar cases was found to be unknown after a review of the literature. This case is an example demonstrating the growing significance of microsurgery in the traumatology.

After reviewing the literary data on the frequency, the etiology, the classification and the anatomical characteristics of the talar fractures authors describe a healed case of a rarely occurring central talus fracture. The bony rebuilding was proven with CT. The importance of the early careful reduction, the performance of operation if necessary and the long lasting release of weight bearing are stressed, and the fact too that the CT, a noninvasive examination, is a valuable means in the judgement of bony rebuilding.

The results of the analysis of 52 central talar fractures and 37 follow-up cases in the 10 year material of the National Institute of Trauma are reported here. They point to the fact, that osteoarthritis can be avoided by appropriate treatment. Two aetiological factors in arthritis are the residual joint surface incongruence and the damage to the blood supply. Immediate, exact reduction and retention, even operatively if necessary and the delay of weight bearing until the restoration of blood supply and the bony architecture are recommended as preventive measures. If doubt arises on the diagnosis of damaged blood supply, intraosseous venography is recommended.

After dislocation or dislocated fracture of the talus late arthrosis is a frequent complication, in which primary bone and cartilage damage play a role. For the demonstration and preclusion, resp., of the vascular damage phlebography performed 3--6 months after the injury is recommended by the authors--by means of which favourable initial experiences could be obtained.

Authors analysing 31 case histories of talus fractures and following the results in 22 cases over a period of 3--12 years support the general view, that the healing of such injuries is satisfactory but partial or even total necrosis may occur. They emphasize the importance of X-ray investigation and occasional phlebography in order to clear up the state of circulation in the bone. Weight bearing should be decided in accordance with these examinations.

The survey literary data on the mechanism, symptoms and treatment of vertical talus neck fractures associated to subtalar dislocations, they present five cases in their practice. Reducement of the fracture dislocation, fixation by Kirschner wire was accomplished and a plaster cast was applied, for twelve weeks as an average. Avascular necrosis of the bone did not occur. The authors lay emphasis on the importance of early careful reducement and immobilization.