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An Eleven-Year Follow-up of a Custom Talar Prosthesis After Open Talar Extrusion in an Adolescent PatientA Case Report
Kuldeep P. Gadkari, MS, MBBS1; John G. Anderson, MD1; Donald R. Bohay, MD1; John D. Maskill, MD1; Michelle A. Padley, BS, CRC1; Lindsey A. Behrend, BS1
1 Orthopaedic Associates of Michigan, 1111 Leffingwell Avenue NE, Suite 100, Grand Rapids, MI 49525. E-mail address for J.G. Anderson: John.Anderson@oamichigan.com
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Investigation performed at Orthopaedic Associates of Michigan, Grand Rapids, Michigan

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2013 Nov 27;3(4):e118 1-4. doi: 10.2106/JBJS.CC.L.00331
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Talar extrusion is an extremely rare injury; isolated cases are reported in most instances1-8. Because of the paucity of literature pertaining to this injury, no definitive recommendations exist for treatment. General consensus among orthopaedic surgeons mandates that this injury be managed by thorough debridement of the wound and reduction of the extruded talus, if possible9. When complications like osteonecrosis and infection occur, the surgeon is left with few options outside of tibiocalcaneal arthrodesis. Often, this leaves the patient with a shortened limb and altered gait mechanics10. In 2007, Stevens et al. reported a talar extrusion in a fourteen-year-old girl who underwent an excision of the native talus because of infection, followed by replacement with a custom-made cobalt-chrome talar body prosthesis11. That case report was unique because of the age of the patient, the use of a metal implant in a previously infected wound, and the use of a custom-made metal prosthesis with a novel “snap-fit” design for purchase and stability. In this case report, we describe the same patient after eleven years of follow-up. The patient was informed that data concerning the case would be submitted for publication.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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