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Fresh-Frozen Osteochondral Allograft Reconstruction of a Severely Fractured TalusA Case Report
Ivan F. Rubel, MD1; Alexandra Carrer, MS1
1 Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York Downstate Medical Center, 450 Clarkson Avenue, Box 30, Brooklyn, NY 11203
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The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Investigation performed at SUNY Downstate-Kings County Medical Center, Brooklyn, New York

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2005 Mar 01;87(3):625-629. doi: 10.2106/JBJS.C.01671
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Talar fractures constitute <1% of all fractures1 and are associated with a high rate of morbidity due to the limited vascularity of the talus and frequent substantial posttraumatic loss of function. Especially challenging are comminuted talar fractures for which reduction and internal fixation is implausible and a tibiotalar and/or subtalar arthrodesis is performed at the cost of joint mobility and hindfoot anatomy.The use of autologous bone-tissue allografts (from the iliac crest or femoral head) to treat talar neck and body fractures has been reported. However, these allograft procedures have been accompanied by primary fusion of one or more of the seven articular surfaces of the talus, most commonly the talocalcaneal, talonavicular, and talotibial joints, leading to considerable loss of function2-4. The use of whole-bone fresh-frozen allografts in the foot has only been reported for the treatment of bone tumors. Muscolo et al. reported on the use of whole fresh-frozen calcaneal allografts for the treatment of chondrosarcoma and giant-cell tumor of the calcaneus5. We are unaware of any previous reports on the use of bulk allografts as an alternative to subtalar arthrodesis for the treatment of severely comminuted fractures of the talus. In an attempt to minimize loss of function, we reconstructed a severely comminuted talar fracture with use of a portion of a fresh-frozen osteochondral talar allograft. We report our results after twenty-nine months of follow-up. The patient was informed that data concerning this case would be submitted for publication.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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