Name of the Procedure:

Talectomy (Astragalectomy)

Summary

Talectomy, also known as astragalectomy, is a surgical procedure that involves the removal of the talus bone from the ankle. This procedure is typically performed to address severe ankle deformities or problems that cannot be corrected by other means.

Purpose

• Medical Condition or Problem: Severe ankle deformities, chronic pain, arthritis, or instability of the ankle.
• Goals or Expected Outcomes: Relief from pain, improved ankle stability, and enhanced overall function and mobility.

Indications

• Severe, chronic ankle pain that is unresponsive to conservative treatments.
• Significant ankle deformity due to arthritis, trauma, or congenital abnormalities.
• Ankle instability that affects daily activities and quality of life.
• Patients who have not found relief from other surgical or non-surgical interventions.

Preparation

• Pre-procedure Instructions: Patients may be required to fast for several hours before surgery. Instructions will be provided for adjusting any medications.
• Diagnostic Tests or Assessments: X-rays, MRI, or CT scans of the ankle to assess the extent of the deformity or damage.

Procedure Description

1. Anesthesia: The patient is placed under general anesthesia or spinal anesthesia.
2. Incision: An incision is made over the ankle.
3. Bone Removal: The talus bone is carefully removed.
4. Joint Stabilization: The surrounding ligaments and bones are stabilized. This may involve the use of internal fixation devices, such as screws or plates.
5. Closure: The incision is closed with sutures, and a bandage or cast is applied.

Duration

The procedure typically takes 2 to 3 hours.

Setting

Performed in a hospital or a specialized surgical center.

Personnel

• Orthopedic Surgeon
• Surgical Nurses
• Anesthesiologist

Risks and Complications

• Common Risks: Infection, bleeding, swelling, and pain.
• Rare Risks: Nerve damage, blood clots, and non-union or poor healing of the bones.
• Possible Complications: Persistent pain or instability, delayed wound healing, and hardware problems.

Benefits

• Relief from chronic pain
• Improved mobility and function of the ankle
• Enhanced quality of life

Recovery

• Post-procedure Care: Pain management with medications, wound care, and keeping the leg elevated.
• Expected Recovery Time: Several weeks to months, depending on individual healing rates.
• Restrictions: Limited weight-bearing on the affected foot initially; gradual reintroduction of activities as directed by the surgeon.
• Follow-up Appointments: Regular visits to monitor healing progress.

Alternatives

• Non-Surgical Options: Physical therapy, orthotic devices, medication management.
• Surgical Alternatives: Ankle fusion (arthrodesis), ankle replacement (arthroplasty).
• Pros and Cons: Non-surgical options pose fewer risks but may not provide sufficient relief. Surgical alternatives may provide similar benefits with varying risks and recovery times.

Patient Experience

• During the Procedure: The patient will be under anesthesia and will not feel any pain.
• After the Procedure: Pain and discomfort managed through medications. Temporary use of crutches or a wheelchair. Gradual improvement in pain and mobility with proper rehabilitation.