Lateral Talus Stress Fracture Non-union Treated with Open Reduction, Bone Grafting and Internal Fixation: A Case Report

Résumé

A 68-year-old gentleman was referred by his general practitioner to the Foot and Ankle elective clinics of the Department of Trauma and Orthopaedics of the Lister Hospital, for investigation of ongoing right ankle pain and persistent swelling. Radiographs revealed mild to moderate degenerative changes of the ankle, but no obvious injury, so an MRI scan was organised which surprisingly, revealed an old non-united longitudinal anterolateral talar fracture with 5mm displacement. Since the fracture was not involving the weightbearing surfaces of the ankle joint, the chosen treatment was open reduction, bone grafting and internal fixation. The surface was prepared with osteotomes and penetrated with 2mm drill. P28 DMB allograft was applied and the fracture was fixed with two 3.5mm PT headless compression screws, perpendicular to the fracture site. 6 weeks later, the check x-rays were satisfactory with early signs of healing and the patient was allowed to mobilise. Consequently, the patient regained full and pain-free range of motion and was able to fully weight-bear with comfort. He had incredibly good outcome at the time of the last follow-up appointment in spite of his delayed presentation and treatment.