Closed Pantalar Dislocations: Characteristics, Treatment Approaches, and Outcomes

Vosoughi, Amir Reza; Vallier, Heather A.

doi:10.5435/jaaos-d-20-00836

Cited by 8 publications

(18 citation statements)

References 30 publications

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“…Close reduction was not successful, because subtalar joint locked in dislocated position and trapped talar neck between flexor tendons. Open reduction was done through anteromedial approach and medial malleolus osteotomy with dislodgment of subtalar joint, then easily satisfactory reduction achieved, a closed reduction should be try initially, than an urgent open method should be done if the talus is not accurately reduced by closed maneuver [4] . There are many opinions regarding the best treating method for closed talar dislocations.…”

Section: Discussionmentioning

confidence: 99%

Closed total (pan-talar) dislocation: A case report

Alessa¹,

Almas²,

Alhadad³

2022

Int. J. Case Rep. Orthop.

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Pan-talar dislocations without talar fracture are rare with serious complication in future like osteonecrosis, and posttraumatic osteoarthritis. There are few reported cases of closed pan-talar dislocations in literature and still, there is no consensus regarding the appropriate treatment. Our reported case of closed pan-talar dislocation for 26-year old healthy male treated successfully by open reduction and internal fixation without radiological and clinical sighs of avascular necrosis and excellent Range of motion (ROM) of the ankle on 2-year follow-up.

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Section: Discussionmentioning

confidence: 99%

Closed total (pan-talar) dislocation: A case report

Alessa¹,

Almas²,

Alhadad³

2022

Int. J. Case Rep. Orthop.

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“…There are different kinds of dislocation in the ankle, hindfoot, and Chopart joints. Isolated calcaneal dislocation should be differentiated from subtalar or pantalar dislocations, in which talonavicular subluxation or dislocation is a featured injury [ 8 ]. Isolated dislocation of the calcaneus from talocalcaneal and calcaneocuboid joints is a very rare injury [ 4 – 6 ].…”

Section: Discussionmentioning

confidence: 99%

Closed isolated anterolateral calcaneal dislocation: a case report

Vosoughi

Akbarzadeh

Zakaee

2022

BMC Musculoskelet Disord

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Background Complete isolated calcaneal dislocation, defined as dislocation of talocalcaneal and calcaneocuboid joints with intact talonavicular joint without significant fracture, is an exceedingly rare injury. Case presentation A 49-year-old man, after a motor vehicle collision, presented with a closed isolated anterolateral dislocation of the calcaneus associated with fracture of the sustentaculum tali, cuboid, lateral process of the talus, and avulsion fracture of superior peroneal retinaculum. Urgent successful closed reduction was immediately performed in the emergency room under sedation. Two days later, through sinus tarsi approach extended proximally to posterior of the lateral malleolus and distally to the calcaneocuboid joint, peroneal tendons were reduced in the retromalleolar groove and avulsion fracture of the superior peroneal retinaculum was reduced and fixed by a suture anchor. A chondral lesion (6 × 8 mm) was seen in the posterior facet of the calcaneus for that chondroplasty and microfracture were performed. Also, small bony fragments from the cuboid were excised. The reduced calcaneocuboid joint was fixed by two Kirschner wires. In the second stage, 10 days later, through medial approach to the talocalcaneal joint, multiple free bony fragments were excised. Then sustentaculum tali was reduced and fixed using a lag screw. Postoperatively, a non-weight bearing short leg cast was applied for six weeks. The patient had permission to start partial weight bearing 6 weeks after removal of K-wires. Finally, at the 10th postoperative week, he had full weight-bearing without any aid instrument. He was able to return to his regular activities about 6 months after the injury. At 34 months, the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale was 92 from 100. The foot function index percentile was 7% and the visual analogue score for pain was 1.9. The last radiographs revealed normal configuration of talocalcaneal, calcaneocuboid, and talonavicular joints with a little joint space narrowing in posterior part of the subtalar joint. Conclusion Patients with isolated anterolateral calcaneal dislocations, even with multiple associated fractures, can have acceptable outcomes, if it is urgently diagnosed and properly managed.

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“…Remarkably, pantalar dislocations (1.6%) were more frequent than the subtalar dislocation (0.8%) in our study. Pantalar dislocation, especially closed types, are very rare [ 26 ]. We think that this may be a bias of our study because the most severely injured cases are usually referred and admitted to our level I trauma center.…”

Section: Discussionmentioning

confidence: 99%

Different patterns and characteristics of Talar injuries at two main orthopedic trauma centers in Shiraz, south of Iran

Vosoughi

Fereidooni

Shirzadi

et al. 2021

BMC Musculoskelet Disord

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Background Categorizing different injury patterns of the talus, describing demographic data, mechanisms of injury and associated fractures are important issues in orthopedic trauma surgeries. Injuries of the talus require careful attention with appropriate treatment approaches in order to reduce possible complications. Methods In a cross-sectional study, the demographic characteristics, mechanism of injury, fracture type, and associated fractures were compiled from all patients’ files and operation notes with diagnosis of talar injuries from January 2014 to December 2019. Results Among 367 patients, 317 (86.4%) males and 50 (13.6%) females with mean age of 31.8 ± 11.6 years were identified. There were three (0.8%) patients with bilateral talar fractures. The most common mechanism of injury was motor vehicle accident (MVA) (46.1%), followed by falls (43.3%), direct trauma (6.2%) and sport injuries (4.4%). About half of the patients injured in MVAs were motorcyclists. Isolated talar body fractures (21.9%) were more common than isolated talar neck (19.2%) or combined body & neck fractures (14.6%). Isolated lateral process fracture is the most frequent fractured process of the talus (14.3%). Hawkin type IIA (39.2%) was the most common type of talar neck, followed by Hawkin type III (22.3%), type I (21.5%), type IIB (14.6%) and type IV (2.3%). Medial malleolus, fibula and calcaneus were the most common associated fractures, respectively. Conclusions The population that is most affected by talar injury are active young men who are involved in motor vehicle accidents, especially motorcycle crashes, with fracture of body and/or neck of talus being the most common type.

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Closed Pantalar Dislocations: Characteristics, Treatment Approaches, and Outcomes

Cited by 8 publications

References 30 publications

Closed total (pan-talar) dislocation: A case report

Closed total (pan-talar) dislocation: A case report

Closed isolated anterolateral calcaneal dislocation: a case report

Different patterns and characteristics of Talar injuries at two main orthopedic trauma centers in Shiraz, south of Iran

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