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Talar dislocations

Ewout S Veltman, Ernst Ja Steller, Philippe Wittich, Jort Keizer
A case of complicated lateral subtalar dislocation is presented and the literature concerning this injury is reviewed. Subtalar joint dislocations are rare and often the result of a high-energy trauma. Complications include avascular necrosis of the talus, infection, posttraumatic osteoarthritis requiring arthrodesis and chronic subtalar instability. Negative prognostic factors include lateral and complicated dislocations, total talar extrusions, and associated fractures. A literature search was performed to identify studies describing outcome after lateral subtalar joint dislocation...
September 18, 2016: World Journal of Orthopedics
David H Ballard, Kevin J Campbell, Lee E Blanton, Jason T Williams, Guillermo Sangster, Anne M Hollister, Alberto A Simoncini
The purpose of this study was to assess the incidence of tendon entrapments and tendon dislocations associated with ankle and hindfoot fractures in patients studied by multidetector computed tomography (MDCT). Additionally, we describe particular tendon injuries associated with specific fractures. This was a retrospective review of all individuals with a trauma-protocol CT for suspected ankle and/or hindfoot fractures during a consecutive 41-month time period at a single Level I Trauma Center. Each patient's images were evaluated by two radiologists and an orthopedic surgeon for tendon entrapment, tendon dislocation, and bone(s) fractured or dislocated...
August 2016: Emergency Radiology
Mohamed Amine Karabila, Mohamed Kharmaz
No abstract text is available yet for this article.
2016: Pan African Medical Journal
R B Simpson, Darryl A Auston
Fractures of the talar neck with subtalar and tibiotalar joint dislocation (AO/OTA 81-B3) represent a treatment challenge for the orthopedic surgeon. The magnitude of deformity and complexity of the pathoanatomy adds to concerns for soft tissue embarrassment to convey an urgency of surgical intervention. Previous studies have described the several techniques for talar reduction, including medial malleolar osteotomy, posterior Schanz pin manipulation, or posteromedial incision to facilitate relocation at the time of definitive open treatment...
March 2016: Journal of Orthopaedic Trauma
J J M Haverkort, L P H Leenen, K J P van Wessem
INTRODUCTION: Talar fractures are a rare type of fractures (less than 1%). They are difficult to treat and outcome is often complicated by arthritis and avascular necrosis. In this article three cases are presented with different types of dislocated talar neck fractures. Anatomy of the talus, treatment, outcome and follow up of these fractures are discussed. Further, review of literature and guidelines for treatment and follow up for dislocated talar neck fractures are discussed. DISCUSSION: The risk of developing arthritis or avascular necrosis of the talus after dislocated talar neck fractures depends on the initial trauma with vascular compromise due to dislocation of the talus...
2015: International Journal of Surgery Case Reports
Heather A Vallier
UNLABELLED: Talus fractures occur rarely but are often associated with complications and functional limitations. Urgent reduction of associated dislocations is recommended with open reduction and internal fixation of displaced fractures when adjacent soft tissue injury permits. Delayed definitive fixation may reduce the risks of wound complications and infections. Restoration of articular and axial alignment is necessary to optimize ankle and hindfoot function. Despite this, posttraumatic arthrosis occurs frequently after talar neck and body fractures, especially with comminution of the talar body...
September 2015: Journal of Orthopaedic Trauma
Alfonso Prada-Cañizares, Ismael Auñón-Martín, Jesús Vilá Y Rico, Juan Pretell-Mazzini
Subtalar dislocations were first described in 1811 as the simultaneous dislocation of the talo-calcaneal and talo-navicular joints without any tibio-talar or talar neck associated fractures. They were classified in 1853 as: medial, lateral, posterior and anterior based on the displacement of the foot in relationship to the talus. These are uncommon injuries, representing approximately 1 % of all traumatic injuries of the foot and 1-2 % of all dislocations, being associated with high energy trauma.Closed reduction of these dislocations should be performed as early as possible to avoid further damage to the skin and neurovascular structures...
May 2016: International Orthopaedics
Stefan Rammelt, Jens Goronzy
Subtalar dislocations make up 1-2% of all dislocations, about 75% of them being medial dislocations. Treatment consists of early reduction under adequate sedation. In cases of soft tissue interposition or locked dislocations, open reduction is warranted. More than 60% of subtalar dislocations are associated with additional fractures, therefore a postreduction CT is recommended. Complications include avascular necrosis of the talus, infection, posttraumatic arthritis, chronic subtalar instability, and complex regional pain syndrome with delayed reduction...
June 2015: Foot and Ankle Clinics
John T Weston, Xiaochen Liu, Meghan E Wandtke, Jiayong Liu, Nabil E Ebraheim
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...
May 2015: Orthopaedic Surgery
Essoh J B Sié, A Traoré, A K Sy, K Soumaro, Y Lambin
Open total talar dislocation is a rare but well known injury. Its management is controversial and fraught with complications such as infection, avascular necrosis, and post-traumatic osteoarthritis. We report the case of a woman sustaining a pure open talar dislocation reduced in the emergency room. Debridement was done three days after the injury in the operating room. There was no infection. One year after surgery she complained of occasional pain. Ambulation was normal. She wore regular shoes. The overall alignment of the ankle, hindfoot, and midfoot was normal...
September 2014: Journal of Clinical Orthopaedics and Trauma
Yulia Melenevsky, Robert A Mackey, R Brad Abrahams, Norman B Thomson
The talus, the second largest tarsal bone, has distinctive imaging characteristics and injury patterns. The predominantly extraosseous vascular supply of the talus predisposes it to significant injury in the setting of trauma. In addition, the lack of muscular attachments and absence of a secondary blood supply can lead to subsequent osteonecrosis. Although talar fractures account for less than 1% of all fractures, they commonly result from high-energy trauma and may lead to complications and long-term morbidity if not recognized and managed appropriately...
May 2015: Radiographics: a Review Publication of the Radiological Society of North America, Inc
R Veselý, J Kočiš, M Kelbl
PURPOSE OF THE STUDY: Total talar extrusion is a rare injury. It is frequently associated with severe soft tissue injury. There is no consensus about an appropriate treatment for an extruded talus. Total extrusion of the talus has a high possibility of avascular necrosis of the talus or infection. The primary goal of this study is a retrospective evaluation of the patients with open total talar dislocation treated by immediate reimplantation. MATERIALS AND METHODS: We evaluated six patients (mean age, 29...
2015: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Jan Bartoníček, Stefan Rammelt, Karel Kostlivý, Václav Vaněček, Daniel Klika, Ivo Trešl
INTRODUCTION: The aim of this study was to analyze the pathoanatomy of the posterior fragment on the basis of a comprehensive CT examination, including 3D reconstructions, in a large patient cohort. MATERIALS AND METHODS: One hundred and forty one consecutive individuals with an ankle fracture or fracture-dislocation of types Weber B or Weber C and evidence of a posterior tibial fragment in standard radiographs were included in the study. The mean patient age was 49 years (range 19-83 years)...
April 2015: Archives of Orthopaedic and Trauma Surgery
Tun Hing Lui
Congenital vertical talus is an uncommon foot deformity that is characterised by a fixed dorsal dislocation of the navicular on the talar head and neck. Left untreated, a congenital vertical talus causes significant long-term disability. We present a case of neglected vertical talus in a middle-aged woman who was successfully treated with resection of the talar head and tendon transfers.
2015: BMJ Case Reports
Haijiao Mao, Zengyuan Shi, Zhenxin Liu, Haiqing Wang, Dachuan Xu
This is a case report of 31-year-old woman who sustained medial subtalar dislocation with navicular and entire posterior talar process fracture. After closed reduction of the subtalar dislocation, compute tomography (CT) demonstrated that the talus fracture involved the entire posterior process and navicular. The fracture of the talus was fixed with a cannulated screw and the navicular was held with two K-wires to the main body using with a minimally invasive approach. Follow-up revealed that the functional and radiographic results were graded as good...
April 2015: Injury
Kapil Bakshi
Tibiotalar dislocation is rare and usually associated with a high-velocity, high-energy impact or extreme sporting injuries. I describe complete tibiotalar dislocation from an unusual mechanism. A 22-year-old mechanic was sitting under a hydraulic lift when it began to leak, lowering the engine on which he was working onto his right lower thigh. This heavy load, without rotational force or high-velocity impact, was transmitted down his foreleg. Because his foot was fixed to the ground, the talus was proximally and vertically displaced, and the distal tibia was forced to the ground, beside his foot, and was contaminated with sand and grease...
January 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Hitesh Lal, Avinash Kumar, Deepak Mittal, Vinod K Sabharwal
Hawkins type III fracture talar neck may sometimes be a nightmare for surgeons to reduce, even intraoperatively. It is difficult to reduce as the talar body is locked into its dislocated posteromedial position out of both the ankle and subtalar joint. Maneuvers of reduction have been described both in dorsiflexion and plantarflexion of ankle, but these are complicated and not tissue friendly. Further, various methods of grasping and pushing the dislocated talar body by use of joysticks and distractors have been advocated...
July 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Sermet Inal, Canan Inal
BACKGROUND: Pediatric comminuted talar fractures are reported to be rare, and treatment options such as minimal internal K-wire fixation without using a tourniquet to prevent avascular necrosis have not previously been investigated. CASE DESCRIPTION: We report a case of a comminuted talar body and a non-displaced neck fracture with dislocation of the tibiotalar, talonavicular and subtalar joints with bimalleolar epiphyseal fractures in an 11-year-old boy due to a fall from height...
2014: Iowa Orthopaedic Journal
Steven A Herbst
Foot and ankle surgical procedures, ranging from simple procedures, such as bunionectomy and correction of hammer toe, to more complex surgery, such as ankle fusion and ankle replacement, are extremely painful. Moreover, there is increasing interest in performing these procedures in an outpatient setting. Nerve blocks are extensively used in foot and ankle surgery, and commonly used techniques include sciatic nerve block with saphenous nerve augmentation; ankle block; and local, digital, or field block. Whereas more extensive blocks are associated with increased medical risk, higher cost, and delayed ambulation, more local approaches may not provide an adequate duration of effect...
October 2014: American Journal of Orthopedics
Yury Bykov
The talus is the most proximal bone of the hindfoot that couples the foot to the leg. It is the second most common fracture of the tarsal bones, second in frequency to the calcaneous. However, overall injuries to the talus are relatively rare, and most surgeons have little experience in managing them. This article discusses fractures of the talus, including injuries to the talar neck, body, head, and processes. Although subtalar dislocations and osteochondral injuries are important topics, they are not addressed in this article...
October 2014: Clinics in Podiatric Medicine and Surgery
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