An Unusual Case of Medial Dislocation of the Subtalar Joint with Fracture of the Talar Body

  • Ahmet Fevzi Kekec Necmettin Erbakan University, Meram Faculty of Medicine, Departmant of Orthopedics and Traumatology, Meram, Konya, Turkey

Abstract

Talus dislocation with a fracture of the body of talus is a relatively rare clinical entity. Medial subtalar dislocation accompanying this type of fracture was reported only once in Germany in 1968. For the past 50 years, there have been no other cases in the literature. In this article, we report the results of surgical treatment and 2-year follow-up of a patient who presented to the emergency department with such an injury. Radiographs of the ankle revealed a subtalar medial dislocation; however, a talus fracture was not detected. An Xray in the lateral projection of the right ankle obtained after closed reduction under sedative anesthesia showed a fracture of the talar body with displacement. Under spinal anesthesia with anteromedial and anterolateral exposure to the ankle joint, fracture was openly reduced and fixed two cannulated screws(4.5 mm)n the day of presentation to support subtalar joint stability, and one 2-mm Kirshner wire was placed toward the calcaneus to the talus. At 2-year follow-up excellent functional outcome of ankle joint was noted without any avascular necrosis of talus or tibiotalar and subtalar arthrosis.

Author Biography

Ahmet Fevzi Kekec, Necmettin Erbakan University, Meram Faculty of Medicine, Departmant of Orthopedics and Traumatology, Meram, Konya, Turkey

Assistant Professor

References

1. Perugia D, Basile A, Massoni C, Gumina S, Rossi F, Ferretti.A Conservative treatment of subtalar dislocations. Int Orthop 2002; 26:56-60.
2. RW B. Rockwood and Green’s fractures in adults. 7th Edition ed. Philadelphia: Lippincott Williams & Wilkins 2001. July 2002
3. Shakked RJ, Tejwani NC. Surgical treatment of talus fractures. Orthop Clin North Am 2013;44(4):521-8.
4. Sneppen O, Christensen SB, Krogsoe O, Lorentzen J.Fracture of the body of the talus. Acta Orthop Scand 1977; 48:317-324.
5. Fortin PT, Balazsy JE.Talus fractures: Evaluation and treatment. J Am Acad Orthop Surg 2001;9:114-27.
6. Ebraheim NA, Patil V, Owens C, Kandimalla Y.Clinical outcome of fractures of the talar body. Int Orthop 2008;32:773-7.
7. Boyd HB, Knight RA.Fractures of the astragalus. South Med J 1942;35:160-7.
8. DeLee JC, Curtis R. Subtalar dislocation of the foot.J Bone Joint Surg Am 1982;64:433-
9. Vallier HA, Nork SE, Benirschke SK, Sangeorzan BJ.Surgical treatment of talar body fractures. J Bone Joint Surg Am 2004; 86-A(Suppl.1(Pt 2)):180-92.
10. Higgins TF, Baumgaertner MR.Diagnosis and treatment of fractures of the talus: a comprehensive review of the literature. Foot Ankle Int 1999; 20(9):595-605.
11. Stake IK, Madsen JE, Hvaal K, Johnsen E, Husebye EE. Surgically treated talar fractures. A retrospective study of 50 patients. Foot Ankle Surg 2016.;22(2):85-90.
12. Rammelt S, Zwipp H. Talar neck and body fractures. Injury 2009; 40(2):120-135.
13. Buckwalter V JA, Westermann R, Mooers B, Karam M, Wolf B. Timing of Surgical Reduction and Stabilization of Talus Fracture-Dislocations. Am J Orthop 2017;.46(6):408-413.
14. Blandfort W, Scharizer E. Medial luxation of the foot below the talus and fracture of the talar body. Monatsschr Unfallheilkd Versicher Versorg Verkehrsmed. 1968;71(11):497-500
Published
2019-10-01
How to Cite
KEKEC, Ahmet Fevzi. An Unusual Case of Medial Dislocation of the Subtalar Joint with Fracture of the Talar Body. Journal of Pakistan Orthopaedic Association, [S.l.], v. 32, n. 03, p. 98-101, oct. 2019. ISSN 2076-8966. Available at: <http://jpoa.org.pk/index.php/upload/article/view/330>. Date accessed: 16 dec. 2019.

Most read articles by the same author(s)

Obs.: This plugin requires at least one statistics/report plugin to be enabled. If your statistics plugins provide more than one metric then please also select a main metric on the admin's site settings page and/or on the journal manager's settings pages.