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Fractures of the talar body often result from high-energy trauma. These fractures are at risk for nonunion and put the talus at risk for avascular necrosis due to an inadequate blood supply. We present the case of a 57-year-old male that presented to our practice with talus fracture nonunion, talar body osteonecrosis, ankle and subtalar posttraumatic osteoarthritis, and deformity including a mild equinus contracture and mild hindfoot varus. Successful ankle and subtalar fusion, talus fracture union, and deformity correction were performed using a circular external fixator with fine wire fixation and compression. This is the first reported case where fusion of both the tibio-talar-calcaneal joints and the talar body nonunion was achieved using external fixation. At the time of this report, the patient is over 3 years postfusion, stands with neutral alignment, is relatively pain-free, is able to resume normal daily activities, and has no progression of talar osteonecrosis.

journal of limb lengthening and reconstruction

Talar body fracture nonunion and osteonecrosis with adjacent arthritis can be successfully treated with tibiotalocalcaneal arthrodesis using circular external fixation