Medial talonavicular dislocation with nondisplaced navicular fracture: A case report

Abstract

Introduction Talonavicular dislocation is a rare injury that usually occurs following high-energy trauma. The mechanism of injury is a force of abduction or adduction applied to the forefoot. In this article, we present a rare case of medial talonavicular dislocation with a fracture of the navicular following low-energy trauma. Presentation of case We report a case of talonavicular dislocation with a navicular fracture in a 25-year-old male. He presented at the emergency department with a history of twisting injury to his left foot. Physical examination revealed an obvious deformity of his foot associated with tenderness. No neurological deficit was present. Radiograph and CT scan showed medial talonavicular dislocation and postero-lateral navicular fracture. Closed reduction was done followed by six weeks in a cast. The patient was followed up for six months and no complications were reported. Discussion Talonavicular dislocation is commonly associated with ligamentous disruption and midfoot fractures. Most studies reported this type of dislocation in association with a fracture of the navicular, cuboid, talus, calcaneus or metatarsal bones as a result of high-energy trauma. However, in our case, the dislocation resulted from low-energy trauma and was associated with a nondisplaced fracture of the navicular and a minimally impacted fracture of the talus that was treated conservatively. Conclusion Since this type of dislocation is rare, it is important to recognize it early to avoid complications such as painful equinovarus deformity. Early reduction and immobilization is the ideal treatment for this injury.

Chopart dislocations: a review of diagnosis, treatment and outcomes

“…ORIF (K wires) 6w of non-WBBK cast. K wires removed at 6w with progressive WB 2 years: no complications Algouaiz et al [ 54 ] 25 M Twisting −ve Medial TNJ swivel dislocation + Navicular fracture XR + CT Closed reduction 6w of non-WBBK cast 6 months: Unable to run due to pain Mathesul et al [ 55 ] 50 M MVA—plantar flexion with axial load −ve Fracture dislocation of the navicular XR + CT Closed reduction + Ex fix and K wires 6w of non-WB Ex-fix and K wires removed at 6w + partial WB, full WB at 12w 12 months: no complications, AOFAS 97 Pillai et al [ 7 ] 45 F Fall from 3 feet −ve Lateral swivel TNJ dislocation with cuboid compression fracture XR Closed reduction + K wire fixation 4w of non-WBBK cast. Cast and K-wires removed at 4w + partial WB and full WB at 10w 24 months: no complications, AOFAS 88 Williams et al [ 56 ] 22 F Inversion when walking −ve Medial swivel TNJ dislocation with cuboid fracture and talar avulsion fracture XR Closed reduction alone 3w of non-WBBK cast followed by progressive WB Full WB at 9w 18 months: intermittent mild discomfort and reduced ability to dance.…”