Features of the treatment of injuries of the talus

The experience in diagnosis and treatment of 52 talus injuries (50 patients) is presented. Inclusion of computer tomography into examination complex allowed to improve the diagnosis accuracy, especially in fractures of talus body and talus blocking in sagittal plane. Eight (16%) patients underwent conservative treatment and 42 (84%) were operated on. Surgical dissection of medial malleolus provides anatomic (preservation of artery deltoideus) and vast approach for the revision of fracture zone. Reposition performed at the early terms as well as stable fixation of talus fragments by sunken metal-devices are the means for the compensation of vascular disturbances (aseptic necrosis). In case of moderate pain syndrome, development of small aseptic necrosis zones and absence of talus prolapse active vascular therapy and delayed tactics are indicated. In marked pain syndrome, vascular disturbances, significant aseptic necrosis of talus with its prolapse the indications to the resection astragalectomy should be considered. Long term results were observed in 43 patients. Good results were achieved in 36 (83.7%) and satisfactory results — in 7 (16.3%) patients.