Comminuted fractures and fracture dislocations of the body of the astragalus: Operative treatment

Abstract

1. 1. The customary treatment for comminuted fractures and fracture dislocations of the body of the astragalus has been astragalectomy or tarsal fusion. Results have, however, not been good. 2. 2. An operation of technical simplicity is suggested for the management of these injuries. Briefly, the principal steps are (1) exposure of the tibio-astragalar joint by means of an anterolateral incision; (2) removal of the fragmented astragalar body; and (3) embedding of a sliding graft from the distal, anterior surface of the tibia into the neck of the astragalus. 3. 3. The considerations of special importance in this operation are that the weight bearing thrust is placed on normal, undisturbed joint tissue and that there is no tendency for subsequent lateral deformity of the foot. 4. 4. Experience indicates that the end result of this procedure should be a painless, normal appearing foot and ankle with good stability and function.