Tibiotalar dislocation without associated fractures

Abstract

A luxação tibiotalar isolada é uma lesão incomum, frequentemente associada a fraturas e relacionada a acidentes de alta energia. Relatamos um caso de um paciente de 24 anos, do sexo masculino, que sofreu um trauma axial resultando em uma luxação pura tibiotalar posterior fechada. O tratamento foi realizado com redução incruenta, imobilização e acompanhamento ambulatorial. Quatro meses após a lesão, o paciente não relatava dor, tinha arco de movimento satisfatório, sem instabilidade residual ou início de osteoartrite pós-traumática. O mecanismo do trauma, o tratamento imediato, a importância da redução fechada e estável e a mobilização precoce são discutidos neste caso.

Isolated talus dislocation: a case report

“…The residual instability remains insignificant, and there are no other losses in cases of adequate diagnosis and treatment (2) . As for the immobilization time, no consensus was reached, but immobilization for at least six weeks is of great value.…”

“…The talus is composed of the foot joint with the ankle, and together with the calcaneus, they are important for ambu-Usually, a dislocation or a fracture of this bone results from severe trauma related to falls from height, automobile accidents, torsional trauma, or even during sports (1,2,5,6) . It mainly affects young males around 30 years of age (1,5,6) .…”

“…In addition, it was also shown that about 80% of the dislocations are medial (1) . These are injuries with a good prognosis, especially those closed if diagnosed correctly and properly reduced, followed by six weeks of immobilization and intensive rehabilitation (2) .…”

Pure Ankle Dislocation: A Case Report and a Narrative Literature Review

“…Although the gold standard treatment (conservative or surgical) for these rare injuries has not yet been established, conservative treatment seems to be the most optimal way of managing closed injuries [ 16 , 17 ]. Prognosis is good with the appropriate treatment and rehabilitation protocol in most cases [ 5 ].…”

“…In a systematic review of Wight et al, the incidence of pure ankle dislocation accounted for 0.065% of all ankle injuries and 0.46% of all presentations with an ankle dislocation [4]. Typically, these injuries are the result of high-energy trauma, such as motor vehicle accidents, falls from height and sports traumas, where the failure of the ligamentous stabilizers predominates [5][6][7]. Although the ankle joint has intrinsic stability (the mechanical efficiency of the ankle mortise, ankle ligaments and the strong capsule), anatomical defects such as hypoplasia of medial malleolus, atrophy of the peroneal muscles, ligamentous laxity and recurrent ankle sprain predispose the ankle joint to dislocation [8,9].…”