PMC4603320_01
Radiograph at initial presentation to our institution, demonstrating nonunion of talar neck fracture below tibiotalar arthrodesis.
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Radiographs (Figure 1) revealed an established nonunion of the talar neck along with subtalar arthritis and calcification of the vessels.
CT scan at presentation: sagittal slices demonstrate size of distal fragment. (a) Medial slice, (b) central slice, and (c) lateral slice.
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It also confirmed a solid tibiotalar fusion and subtalar arthritis as per the plain radiology (Figures 2 and 3).
CT scan at presentation: axial slices demonstrate size of distal fragment.
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It also confirmed a solid tibiotalar fusion and subtalar arthritis as per the plain radiology (Figures 2 and 3).
Immediate postoperative radiograph.
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Three 6.5 mm partially threaded cannulated screws were placed to secure the fusion: from the calcaneus to the distal tibia, from the calcaneus to the anterior talus, and posteroanteriorly across the talar nonunion (Figure 4).
Three-month postsurgery radiographs.
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At a three-month postoperative review in October 2013, the patient reported no pain around the ankle and subtalar joint, and the plain radiograph showed progression of union (Figure 5).
CT demonstrating subtalar fusion and some union across talar neck.
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A CT scan was requested to assess union in more detail (Figure 6) prior to removal of the walker boot.