[Treatment of non-traumatic avascular talar necrosis by transposition of vascularized cuneiform bone flap plus iliac cancellous bone grafting].

Abstract

OBJECTIVE: To evaluate the outcome of cancellous bone grafting plus iliac cancellous bone in the treatment of non-traumatic avascular talar necrosis. METHODS: Twenty patients, 14 males and six females, eight at stage II, ten at stage III and three at stage IV according to the modified Ficat & Arlet necrosis classification system, were treated with vascularized bone flap from January 2000 to June 2005. RESULTS: All patients were followed up for a mean of 37 months (range: 14 to 68 months). The clinical function outcome evaluated by Kenwright criteria were excellent in 8 cases, good in 10 cases, fair in 1 case and poor in 1 case. Clinical symptom was completely or partially relieved. The necrotic area was filled with newly formed bone and the excellent-to-good rate was 90%. CONCLUSION: Transposition of vascularized cuneiform bone flap plus iliac cancellous bone grafting may be an ideal therapeutic method for non-traumatic avascular talar necrosis. And the clinical outcome is satisfactory.