Complications and Functional Outcomes After Pantalar Dislocation

Abstract

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

A Case Report of an Open Pan-Talar Dislocation

“…Extreme supination and plantarflexion forces result in talar dislocation out of the ankle mortise, with disruption of the strong ligamentous attachments, which can result in an open injury [4]. Most of the literature describes talar extrusion with an anterolateral wound, which is similar to our case report [5][6][7][8][9].…”

“…When facing a case of open talar extrusion, we should consider the possible complications including avascular necrosis, infection, post-traumatic arthritis and the need for secondary procedures [3][4][5][6][7][8]. Hiraizumi et al concluded that the risk of avascular necrosis was the highest in the cases where no further attached soft tissue to the talus [9].…”

“…Open talar extrusion is commonly complicated by soft tissue infection with a potential rate of infection ranges from 25% to 38% of cases [7,11] versus 88.9% initially reported by Detenbeck and Kelly [12]. However, infection risk has been minimized in the recent literature due to improvement in the wound care staged procedures and appropriate antibiotic therapy [6,8].…”

“…Traditionally, the literature described talectomy with tibio-calcaneal arthrodesis as the treatment of choice for an open total talar dislocation. However, recently talar reimplantation after thorough debridement demonstrated satisfying short and long-term clinical outcomes with the advantage of retaining the talar height and bone stock [3][4][5][6][7][8]11,12].…”

“…Most commonly, these injuries are open and are associated with a high rate of complications including avascular necrosis, infection, post-traumatic arthritis and the need for secondary procedures. Historically, primary talectomy and tibiocalcaneal arthrodesis were recommended to diminish the rate of these complications; however, recent literature advocates surgical debridement and re-implantation with stabilization [3][4][5][6][7][8].…”