Delayed debridement of an open total talar dislocation reimplanted in the emergency room

Abstract

Open total talar dislocation is a rare but well known injury. Its management is controversial and fraught with complications such as infection, avascular necrosis, and post-traumatic osteoarthritis. We report the case of a woman sustaining a pure open talar dislocation reduced in the emergency room. Debridement was done three days after the injury in the operating room. There was no infection. One year after surgery she complained of occasional pain. Ambulation was normal. She wore regular shoes. The overall alignment of the ankle, hindfoot, and midfoot was normal. Movements of the tibiotalar and subtalar joints were not impaired. She has resumed her regular activities. Radiographs showed no signs of avascular necrosis. All components of the treatment strategy of open total dislocation should be carried out in emergency. This results in environment close to the original biological state. Good results can be achieved if infection is avoided.

Manual Reduction and Plaster External Fixation for the Treatment of Closed Total Talus Dislocation: Case Report and Literature Review

“…CT examination can determine the extent and scope of the fracture, 19 and MRI could detect early signs of avascular necrosis. 20 All the above examinations would help to assess trauma severity and determine causes of treatments. These are of great significance for assessing damage and therefore guiding treatment and prognosis.…”

“…The simple X‐ray examination may lead to missed diagnosis and misdiagnosis, resulting in serious consequences. CT examination can determine the extent and scope of the fracture, 19 and MRI could detect early signs of avascular necrosis 20 …”