Bilateral talus fracture dislocation: is avascular necrosis inevitable?

Abstract

SUMMARYBilateral simultaneous fracture dislocation of the talus is a very rare injury. It occurs usually following high-velocity injuries. We report a 45-year-old man who presented with bilateral talar fracture dislocation following a heavy stone falling on him. On his right side, he had open talus dislocation with lateral process fracture and on his left side he had closed talar neck fracture dislocation. He underwent immediate debridement and external fixator application for his right side and open reduction and internal fixation for his left talus. At the end of 34 months' follow-up, he was able to walk up to 2 km without pain. His ankle range of movements were restricted bilaterally. Radiographs revealed bilateral avascular necrosis with right side showing complete collapse. We present this case for its rare presentation of bilateral talar fracture dislocation with bilateral avascular necrosis with sequential radiographs. BACKGROUND

Optimizing Orthopedic Outcomes in Complex Bilateral Talus Fracture-dislocations with Medial Malleolus Injuries: A Comparative Analysis of Surgical Approaches and Long-term Results

“…We discover a positive result when we compare the patient’s patient’s post-operative results to the current literature. The patient had a good range of motion and reported no pain, which is consistent with other cases in the literature [ 1 , 2 , 4 , 7 ] ( Table 1 ).…”

“…Hawkins described fractures occurring in the neck of the talus with their associated joint dislocations [ 3 ]. These complex injuries pose unique challenges due to the risk of complications, including avascular necrosis and post-traumatic arthritis [ 2 , 4 ]. Despite the use of suitable interventions and anatomical fixation, these injuries injuries have a poor prognosis [ 2 ].…”

An Unusual Inverted Talar Neck Fracture–Dislocation

“…This has been described specifically only once in previous literature [ 9 ]. Other reports have described bilateral talar neck involvement, entrapment of the neurovascular and tendinous structures, concomitant talar, malleolar, and calcaneal fractures [ 10 – 15 ]. We offer an updated report to highlight treatment decision-making in timing, reduction, and fixation, along with patient outcomes.…”