Treatment of talar necrosis complicated by severe infection.

Talus necrosis complicated by osteomyelitis and extensive soft-tissue infection poses a difficult therapeutic challenge, and limb salvage is often difficult to achieve. Between 1986 and 1999, 23 patients were treated for talar osteomyelitis and infection of the soft-tissue envelope. Limb salvage with a tibiocalcaneal arthrodesis was attempted in 16 cases; seven patients had amputations. External fixation was used in all patients; four patients had a callous distraction. Thirty-seven additional procedures were necessary to treat the infection. There were eight complications in seven patients. After an average period of 31 months (range 13–81 months) follow-up evaluation was available in 12 of the 15 cases. Solid union of the arthrodesis was achieved in all patients and there were no infectious recurrences. The clinical results were excellent in one patient, good in six, fair in four and poor in one case. Considering the extent of infectious destruction, a tibiocalcaneal arthrodesis can be regarded as a limb salvage procedure, in selected patients, which yields satisfactory long-term results. [ABSTRACT FROM AUTHOR]