Peritalar dislocation

PURPOSE OF THE STUDY: The aim of this prospective study was to present injury characteristics and to evaluate therapeutic procedures and midterm functional and radiographic results of the surgical management of talus fractures. MATERIAL AND METHODS: In the period from January 1, 2004, to December 31, 2009, a total of 53 patients with 56 talar bone fractures or peritalar dislocations were treated surgically. The prospective study included 39 patients with 42 fractures of the talar neck and body; of these, 31 men had 34 fractures (79...

Total talar dislocation, ie, disruption of the talus from the calcaneus, navicula, and tibia, is a rare and severe injury. We present a case of closed peritalar dislocation without any accompanying fractures and, thus, discuss the conflicts encountered in this rare injury. A 25-year-old male patient presented with severe pain, swelling, and deformity in his right ankle within 30 minutes of a fall from a height. There were no wounds around the ankle. Radiographs revealed that the talus was disrupted from the calcaneus, navicula, and tibia moving in the anterolateral direction...

Major fractures and dislocation of the talus and peritalar joint are uncommon. We present here a very rare case of injury with delayed presentation of closed total talus dislocation with fractured medial malleolus and posterior talar tubercle fracture. This report analyzes previous reports in the literature and the proposed treatment.

Secondary anatomical reconstruction of malunions or nonunions after talar fractures or fracture-dislocations with preservation of all three joints aims at maximal functional rehabilitation. A corrective osteotmy or revision of a pseudoarthrosis with axial realignment and internal fixation was carried out in 22 patients (aged 15 to 50) at a mean of 9 (range, 1.5 to 45) months after having sustained a fracture of the talar head, neck or body. 20 patients were followed for a mean of 4.8 (range, 1.5 to 14) years after reconstruction...

Because of the effect on hindfoot kinematics, missed or delayed diagnosis of peritalar injuries often results in impairment. The seemingly innocuous nature of these injuries, subtle radiographic findings, and low incidence limit familiarity, thereby increasing the likelihood of misdiagnosis. Because of delay in diagnosis, salvage arthrodesis may be necessary to restore function to the extremity. Talar head fracture, talar process fracture, subtalar fracture-dislocation, transverse tarsal joint fracture, and transverse tarsal ligamentous disruption with instability are recurrently misdiagnosed...

Subtalar dislocation is considered a severe injury but occurs rarely and studies generally refer to relatively small patient collectives. We investigated the functional outcome in 22 cases to determine the long-term prognosis. Since associated foot injury is common, we compared the outcome for 12 cases of isolated subtalar luxation with 10 cases of collateral fractures of the adjacent bones of the hind foot and Talus. 19 cases of complex, partially open injuries after high energy trauma have got excluded because of the apparently poor long-term results...

Peritalar dislocation is a term that has been described as an injury involving a simultaneous dislocation to both the subtalar and talonavicular joints without a fracture of talar neck or tibiotalar disruption. It often results from high-energy trauma but may also result from sports injuries. It occurs most frequently with a medial dislocation and less frequently with a lateral, anterior, or posterior dislocation. The treatment for most peritalar dislocations is closed reduction, although surgical intervention may be a requirement in cases where reduction is unobtainable...

We report a medial peritalar dislocation, which was treated with closed reduction and cast for 3 weeks. At follow up 12 months later, there was normal range of motion and mild pain after prolonged walking.

Total dislocation of the talus is a rare and severe injury. We report a case of an open total anterolateral dislocation of the left talus with simultaneous contralateral open peritalar dislocation. The former injury was managed with a primary talectomy because of severe contamination and blood supply deprivation. Thirteen years later, the patient complains of mild symptoms on the talectomy side. In contrast, the patient has more serious clinical problems (panarthritis) on the side of the peritalar dislocation...

From 1987-2003, 36 patients were treated for talar dislocation, 27 patients for subtalar, six for total talar, and three patients for peritalar dislocation. Luxatio pedis sub talo: We found 19 medial closed, seven lateral closed and one third degree open subtalar dislocations. Our therapeutic concept provides for immediate reduction, which is possible by closed procedure for the majority of medial dislocations. If there is a tendency to redislocation, we perform talonavicular K-wire transfixation. In the case of irreducibility, open reduction via lateral approach is the rule...

The purpose of this study is to retrospectively evaluate 18 consecutive cases of peritalar dislocations referred to our department during a period of 25 years and to delineate the factors influencing long-term prognosis. There were 13 (73%) medial and 5 (27%) lateral dislocations. Six patients (33%) suffered an open injury, including 2 of 13 (15%) medial and 4 of 5 (80%) lateral dislocations. Associated fractures involving the hindfoot or forefoot were noted in 7 feet, including 3 of 5 lateral dislocation cases...

The incidence of the peritalar dislocations has been estimated to be approximately 1% of all dislocations. If they are missed, the consequences are serious and lead to an important surgery of the hindfoot. Lateral dislocation is most rare than medial dislocation. The diagnosis of this lesion often requires X-rays of the foot. The CT-scan allows to confirm the diagnosis and to appreciate the associated intra-articular fracture. The reduction must be realized in urgency under anaesthesia. If the orthopaedic reduction is impossible, the surgery allows to obtain an anatomical reduction with the removal of obstacles and the fixation of the associated intra-articular fractures...

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In this paper, a case of closed medial subtalar dislocation and accompanying talar head fracture in a 22-year-old man which occurred while walking on a downhill road is reported. Closed reduction under general anesthesia was unsuccessful. The obstacle for closed reduction was determined at surgery for open reduction and internal fixation as buttonholing of the talar head through the extensor retinaculum. At the 26-month follow-up, he was pain-free in his daily activities.

METHODS: Between 1980 and 1996 we treated 23 patients for dislocated fractures of the talus. The injury was caused by a car accident in 61% and a high fall in 22%. Five patients had open wounds (22%), two developed compartment syndrome of the foot (9%) at an early stage, and 11 patients had multiple injuries. We used the classifications of Hawkins and Marti/Weber. All fractures were surgically treated by fixation with screw osteosynthesis, percutaneous wire transfixation, and/or external fixation...

Posterior tibial tendon dysfunction (PTTD) is a complex multifaceted condition that can affect the lower extremity. Rarely mentioned 20 years ago, today it is the subject of numerous articles, books, and is a topic at most scientific seminars relating to the foot and ankle. It is a muscle imbalance initiated by a rupture, avulsion, or chronic inflammation of the tibialis posterior tendon. With time, it progresses from a flexible to rigid flatfoot deformity. Left untreated, peritalar dislocation and degenerative joint disease may develop...

Arthrodesis of the subtalar joint is well recognized treatment option for moderate or severe flatfoot associated with adult acquired flatfoot secondary to posterior tibial tendon dysfunction. The success of the subtalar arthrodesis is dependent on restoration of normal bony relationships in the hindfoot and midfoot. For this reason, a distinction is made between a repositional arthrodesis and the traditional in situ type of arthrodesis. An in vitro study of the adult acquired flatfoot identifies an anteroposterior subluxation of the subtalar articulation that can be corrected durably and reliably through a repositional talocalcaneal arthrodesis...

BACKGROUND: The successful correction of flatfoot in children through lengthening of the lateral column, osteotomy of the medial cuneiform, and advancement of the posterior tibial tendon led to the introduction of similar procedures to treat acquired pes planovalgus secondary to attrition or rupture of the posterior tibial tendon in adults. However, to our knowledge, no study has been published documenting whether these procedures are effective treatment for acquired flatfoot in adults...

PURPOSE OF THE STUDY: The aim of this study was to emphasize the anatomical particularities of congenital vertical talus. We propose a one stage operative procedure adapted to the deformities. MATERIALS AND METHODS: A retrospective study of 24 children with congenital vertical talus was conducted. An etiology was observed in 58 per cent of cases and 42 per cent were considered as idiopathic. From a radiological analysis of 39 feet, we precise the anatomical particularities...

Five patients with peritalar dislocations were identified in a search for injuries of the talus. We report the mechanism, management, and outcome of their injuries and compare and contrast the injuries with the same injury in adults. To our knowledge, our series is the only small series of this rare injury in children. Four of our 5 patients had acceptable results with respect to pain and gait. In two patients, the peritalar dislocation was missed, necessitating a delay in management because more attention is focused on obvious fractures, when they exist...