The Duke Orthopaedic Journal

Register      Login

VOLUME 8 , ISSUE 1 ( June, 2018 ) > List of Articles


Iatrogenic Talar Avascular Necrosis Secondary to Lateral Ligament Reconstruction Suture Anchor Placement requiring Total Talar Replacement

Selene G Parekh, Sawley A Wilde, Evan M Guerrero

Keywords : Avascular necrosis, Lateral ligament reconstruction, Talus, Total talus.

Citation Information : Parekh SG, Wilde SA, Guerrero EM. Iatrogenic Talar Avascular Necrosis Secondary to Lateral Ligament Reconstruction Suture Anchor Placement requiring Total Talar Replacement. The Duke Orthop J 2018; 8 (1):7-10.

DOI: 10.5005/jp-journals-10017-1086

License: CC BY-NC 3.0

Published Online: 01-04-2017

Copyright Statement:  Copyright © 2018; The Author(s).


Lateral ankle instability is a common sequela of ankle sprains. Surgical treatment may be required if nonoperative treatment fails, and the modified Broström procedure is considered the gold standard. Many techniques have been described, with a suture anchor in the lateral malleolus commonly utilized. More recently, suture implants with surgical tape have been introduced. These are proposed to provide immediate stability, allowing more aggressive rehabilitation. However, they require a 3.4 mm drill hole in the talus, along with the 2.7 mm drill hole in the fibula. We present a case of avascular necrosis (AVN) of the talus after utilization of this suture tape construct, requiring total talus replacement.

PDF Share
  1. Hamilton WG, Thompson FM, Snow WS. The modified Brostrom procedure for lateral ankle instability. Foot Ankle 1993;14(1):1-7.
  2. Hassan S, Thurston D, Sian T, Shah R, Aziz A, Kothari P. Clinical outcomes of the modified Broström technique in the management of chronic ankle instability after early, intermediate, and delayed presentation. J Foot Ankle Surg 2018 Apr 11. pii: S1067-2516(17)30697-X.
  3. Colville M. Surgical treatment of the unstable ankle. J Am Acad Orthop Surg 1998 Nov-Dec;6(6):368-377.
  4. Karlsson J, Bergsten T, Lansinger O, Peterson L. Reconstruction of the lateral ligaments of the ankle for chronic lateral instability. J Bone Joint Surg Am 1988 Apr;70(4):581-588.
  5. Lui TH. Modified arthroscopic Brostrom procedure. Foot Ankle Surg 2015 Sep;21(3):216-219.
  6. Cho BK, Kim YM, Kim DS, Choi ES, Shon HC, Park JC. Outcomes of the modified Brostrom procedure using suture anchors for chronic lateral ankle instability—a prospective, randomized comparison between single and double suture anchors. J Foot Ankle Surg 2013 Jan-Feb;52(1):9-15.
  7. Cottom JM, Rigby RB. The “all inside” arthroscopic Broström procedure: a prospective study of 40 consecutive patients. J Foot Ankle Surg 2013 Sep-Oct;52(5):568-574.
  8. Giza E, Shin EC, Wong SE, Acevedo JI, Mangone PG, Olson K, Anderson MJ. Arthroscopic suture anchor repair of the lateral ligament ankle complex: a cadaveric study. Am J Sports Med 2013 Nov;41(11):2567-2572.
  9. Angirasa AK, Barrett MJ. Talar anchor placement for modified Brostrom lateral ankle stabilization procedure. J Am Podiatr Med Assoc 2008 Nov-Dec;98(6):473-476.
  10. Li X, Killie H, Guerrero P, Busconi B. Anatomical reconstruction for chronic lateral ankle instability in the highdemand athlete: functional outcomes after the modified Brostroem repair using suture anchors. Am J Sports Med 2009 Mar;37(3):488-494.
  11. Yoo JS, Yang EA. Clinical results of an arthroscopic modified Brostrom operation with and without an internal brace. J Orthopaed Traumatol 2016 Dec;17(4):353-360.
  12. Mulfinger GL, Trueta J. The blood supply to the talus. J Bone Joint Surg Br 1970 Feb;52(1)160-167.
  13. Vallier HA, Reichard SG, Boyd AJ, Moore TA. A new look at the Hawkins classification for talar neck fractures: which features of injury and treatment are predictive of osteonecrosis? J Bone Joint Surg Am 2014 Feb;96(3):192-197.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.