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Acta Ortopédica Mexicana

ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología
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2010, Number 6

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Acta Ortop Mex 2010; 24 (6)

Anterior enucleation of a talus with «triple loss of relations». Case report and literature review

García-Juárez JD, Tohen-Bienvenu A, Lozano-Reyes S, Jiménez-Cabuto C
Full text How to cite this article

Language: Spanish
References: 7
Page: 420-423
PDF size: 65.37 Kb.


Key words:

astragalus, foot, dislocation, arthrosis, ankle, necrosis.

ABSTRACT

Introduction: When the talus loses its triple connection with the ankle mortise, a rare injury occurs in 3-4% of the ankle dislocations; 75% of the injuries are open. A clinical case is presented herein, together with its clinical course and a review of the literature. Clinical case: The case of a male, 52 year-old patient with a left ankle inversion and extension injury is presented. At the time of admission to the emergency room he had triple closed anterior dislocation of the talus. Closed reduction was performed under anesthesia, an acrylic boot was placed and he was followed-up at the outpatient service. Results: The patient did well and was immobilized initially with an acrylic foot-thigh brace for six weeks; he then wore an acrylic suropodalic brace for 4 weeks and started partial weight bearing with crutches at 10 weeks; total weight bearing with crutches at 12 weeks, and without crutches at 16 weeks. Shortly before this a bone scan was performed and no signs of avascular necrosis were found. Conclusions: Triple talar dislocation is a rare injury and its major complication is avascular necrosis and secondary arthrosis that could result in the need for panastragalodesis; the prognosis depends on the timeliness of care, it is a true emergency.


REFERENCES

  1. Asselineau A, Augereau B, Bombart M: Partial or total enucleation of the talus. Vallue of the conservative treatment. A propos of 8 cases. Rev Chir Orthop Reparatrice Appar Mot 1989; 75(1): 34-9.

  2. Murat J, Caltran B: Exterior enucleation of the astragalus associated with ankle Trauma. Lyon Chir 1968; 64(1): 144-5

  3. Hadji M, Golli M, Maoalla R: Conservative treatment of talar dislocation: A case report. Rev Chir Orthop Reparatrice Appar Mot 2004; 90(3) :485-8.

  4. Hidalgo AM, García S, Haeras J: Posteromedial dislocation of the talus. A case report and review of the literature. Acta Orthop Belg 1991; 57(1): 63-7.

  5. Bas T, Vicent P, Alcantara A : Complete dislocation of the talus: a report of 5 cases. The Foot 1994; (4): 102-5.

  6. Gaskin, Pimple M: Closed total talus dislocation without fracture: report of two cases. Eur Orthop Surg Traumatol 2007; 17: 409-11.

  7. Montoli C, De Pietri M, Barbieri S: Total extrusion of the talus: A case report. J Foot Ankle Surg 2004; 43(5): 321-6.




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Acta Ortop Mex. 2010 Nov-Dic;24