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Avascular
necrosis of the talus is routinely associated with talar body and talar neck fractures. Timeline can vary from as early
as 6 months and as far out as 2 years. The condition
can be global leading to severe DJD and collapse of the talar dome.
Treatment for AVN of the talus can vary
from ankle fusion to allograft ankle transplantation.
AVN can also occur in cases without
fracture. The area of necrosis will often be isolated and treatable without requiring an ankle fusion. The key
is always early diagnosis.
In any form, some key factors that will advance the process is weight, diabetes and
above all smoking. It is crucial for patients to stop smoking.
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Sclerotic areas with adjacent cystic changes
in the talus
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Medial talar body is sclerotic - dead section
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Not very common to see AVN after an ankle
fracture, but it can occur even after an ankle sprain
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Fracture was satisfactorily reduced, but
patient lost almost 40% of the cartilage which was delaminated at the time of the injury
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One year later, cystic changes and collapse
of the medial talar dome
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Very dramatic case of AVN
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Another case, watch the progression
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14 months later, joint narrowing is significant
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Another case with collapse and severe subtalar
DJD
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