A case of closed total dislocation of talus and literature review

Ibrahimi, Abdelhalim El; Shimi, Mohammed; Elidrissi, Mohammed; Daoudi, A.; Elmrini, Abdelmajid

doi:10.1016/j.ajem.2010.04.021

Cited by 15 publications

(22 citation statements)

References 4 publications

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“…Avascular necrosis of the talus is the most feared complication of total talar dislocation, often resulting in poor outcomes and the need for arthrodesis. Other authors have reported that infection and fractures of the talus (especially Hawkins type III/IV fractures) both increase the risk of AVN.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of Total Dislocation of the Talus

Weston

Liu

Wandtke

et al. 2015

Orthopaedic Surgery

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This review summarizes the treatment and resulting outcomes for total talar dislocation. The PubMed database was searched for articles about humans with total talar dislocation published in the English language in the last twenty years. The following data were entered into a Microsoft Excel spreadsheet: type of dislocation, nature of associated fractures (if any), type of reduction/fixation utilized, immobilization, weight-bearing status, outcome, complications and average follow-up time. Thirty-nine articles reporting a total of 86 cases of total talar dislocation are included in this review. Seventy-three of these were open injuries and 13 closed. Forty-three cases had an associated foot or ankle fracture, 32 of those cases specifically having a fracture of the talus. The talus was preserved in the initial management of 74 cases, whereas the remaining 12 cases were managed by primary talectomy. The mean duration of follow-up was 32 months. Twenty-two cases required a secondary arthrodesis or another additional procedure. A good outcome was achieved in 35% of cases, a fair outcome in 37% and a poor outcome in 27%. The complication of avascular necrosis (AVN) occurred in 22 cases and 14 subjects developed clinically significant osteoarthritis. Generally, the outcome of current treatments associated with total talar dislocation is not ideal, only 1/3 of cases achieving good outcomes. So far, preservation of the talus is the best treatment option. AVN is still a relatively common complication even in the absence of fracture or postoperative infection.

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Section: Discussionmentioning

confidence: 99%

A Systematic Review of Total Dislocation of the Talus

Weston

Liu

Wandtke

et al. 2015

Orthopaedic Surgery

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“…This can be achieved by closed or open reduction. Mitchell, 24 Xarchas et al, 18 Taymaz and Gunal, 19 Papanikolaou et al, 21 El Ibrahimi et al, 10 Segal and Wasilewski, 20 Newcomb and Brav, 27 and Kenwright and Taylor 8 reported successful closed reduction in cases of closed anterolateral TTD under spinal or general anesthesia in which manual longitudinal traction of the foot was done in addition to countertraction of the leg with the knee flexed to relax the Achilles tendon and posterior leg muscles then pushing the talus backward, except for Segal and Wasilewski 20 who added lateral rotation to the traction and El Ibrahimi et al 10 who added plantar flexion. The difficulty in closed reduction that we faced in the present case was reported in many previous studies, 11,22,27 which is in disagreement with Mitchell 24 who found that the reduction was easy.…”

Section: Discussionmentioning

confidence: 99%

“…14 It occurs commonly as an open injury with or without talar extrusion 5,12,13,[15][16][17] and less commonly as a closed injury. 10,11,[18][19][20][21][22][23][24] The treatment methods of open TTDs are variable in the literature; in addition to the necessary debridement of open wounds and fixation of associated fractures, they vary from closed 1 or open reduction, 22,23 to talectomy with tibiocalcaneal arthrodesis. 5,25 Treatment of closed TTDs is controversial.…”

Section: Introductionmentioning

confidence: 99%

Closed anterolateral total talar dislocation: a case report and technical notes

Alrashidi¹,

Wali²,

Khoshhal³

2014

ORR

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Standard treatment of closed total talar dislocations (TTDs) is a controversial issue due to the rarity of the injury. Case presentation: We report a case of closed anterolateral TTD in a 30-year-old male treated successfully by a closed reduction technique with no radiological evidence of avascular necrosis on 1 year follow-up. Conclusion: Closed reduction has become the preferred modality of management of closed anterolateral TTD. This case supports, as found in recent literature, that closed reduction if possible in similar cases may yield a better outcome, although there is a need for high-level studies to prove the superiority of such a modality.

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“…In TTD, the dislocation of the talus from the tibiotalar, subtalar, and talonavicular joints is commonly associated with malleolar or talar fractures. High‐energy trauma, such as a fall from a height or a motor vehicle accident, is a common cause . TTD is considered to be the result of maximum pronation or supination coupled with plantar flexion force.…”

Section: Casementioning

confidence: 99%