War injuries of the talus

Abstract

Twenty-eight patients with war fractures of the talus were reviewed to determine the incidence of infection and late functional results. The average age of our patients was 37.5 years. Twenty-one injuries were explosive fractures that resulted from shell fragments or mines; seven fractures resulted from gunshot missiles. Seven patients had isolated talus injuries, whereas 21 patients had associated fractures of other bones of the foot or lower leg. All patients were initially treated with debridement, tetanus immunization, intravenous antibiotics, and stabilization, either with cast immobilization or an external fixator. Five days after injury, wound cultures were positive in 25 of 28 feet. Infection was eventually eradicated in all patients, allowing for soft tissue coverage. One patient eventually required a below-knee amputation. The patients were reviewed for functional outcome at 36 to 60 months after injury. Most patients reported a certain degree of residual complaints. The overall result can be considered excellent in only one patient.