CASE: Complete extrusion of the talus is rare and associated with high rates of complications including infection, osteonecrosis, persistent pain and stiffness, and post-traumatic arthritis. Less well described is associated midfoot instability. We report a case of a complete extruded missing talus that resulted in significant midfoot instability treated with a modified triple arthrodesis of the tibiocalcaneal, tibionavicular, and calcaneocuboid joints.CONCLUSIONS: This approach resulted in a radiographic fusion at 3 months without complication, acceptable subjective and Patient-Reported Outcome Measurement System (PROMIS) scores at the 18-month follow-up, and presents a viable treatment strategy in the case of a complete extruded missing talus.