Free microvascular iliac crest flap for extensive talar necrosis--case report with a 16-year long-term follow up.

Détails

ID Serval
serval:BIB_BBB4C51999F9
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Institution
Titre
Free microvascular iliac crest flap for extensive talar necrosis--case report with a 16-year long-term follow up.
Périodique
Microsurgery
Auteur(s)
Rieger U.M., Haug M., Schwarzl F., Kalbermatten D.F., Hintermann B., Pierer G.
ISSN
1098-2752[electronic]
Statut éditorial
Publié
Date de publication
2009
Volume
29
Numéro
8
Pages
667-671
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Atraumatic osteonecrosis of the talus can be extremely painful and lead to significant functional impairment. Although clinical, radiographic, and demographic characteristics of atraumatic osteonecrosis of the talus have been well documented, the diagnosis is frequently missed or delayed; the most common causes are use of corticosteroids and the presence of immune disorders. Operative treatment of large osteochondral lesions of the talus is difficult because the blood supply is poor in the talar dome. Microvascular reconstruction of the talar dome with iliac crest autografts is a complex but functionally excellent therapeutic option. We present a 48-year-old man, who developed an extensive atraumatic avascular necrosis of the talar dome without collapse. Except for insulin dependent diabetes mellitus no further comorbidities were known. A microvascular iliac crest bone flap was inserted into the talus. A follow-up 16 years postoperatively showed a clinically as well as radiographically stable reconstruction of the talar dome and an excellent mobility of the ankle joint. The AOFAS hindfoot scale had improved from initially 33 points to 100 on the last follow-up. Free microvascular bony reconstruction of the talar dome should not only be considered in younger patients but also for middle aged active patients, since our follow-up shows an excellent long term result. Early reconstruction can prevent collapse of the talar bone.
Pubmed
Web of science
Création de la notice
16/12/2009 17:21
Dernière modification de la notice
20/08/2019 16:29
Données d'usage