Extruded Talus Injuries: A Cross-sectional Survey of Indian Orthopedic Surgeons

Introduction: Management of extruded talus (ET) injuries poses a dilemma, owing to its rarity as well as the paucity and diversity of the published literature. Materials and methods:We designed an eight-item questionnaire-based survey, which was administered to Indian orthopedic surgeons.Results: A total of 379 participants completed the survey, 265 (69.9%) reported having seen or treated a case of ET; 172 participants reported following up their case for >1 year.Of these, 33 cases (8.7%) had a well-retained talus without any evidence of avascular necrosis (AVN), arthrosis, or infection; 104 (27.4%) cases had AVN with or without infection; 42 (11.1%)cases developed ankle arthrosis and the talus was not retained and arthrodesis done in 12 (3.1%)cases.A total of 235 (62%) participants chose AVN as the most feared complication, followed by infection (20.3%, n = 77) and arthroses (7.4%, n = 28); 359 (94.7%) participants preferred primary repositioning of ET; 320 (84.4%) participants were not aware of any studies reporting long-term outcomes of these injuries.Conclusion: Most Indian surgeons prefer primary repositioning of ET to talectomy and arthrodesis.Avascular necrosis remains the major concern after repositioning.Awareness on long-term outcomes of these injuries is lacking, and more studies reporting long-term outcomes are needed.