Optimizing Orthopedic Outcomes in Complex Bilateral Talus Fracture-dislocations with Medial Malleolus Injuries: A Comparative Analysis of Surgical Approaches and Long-term Results.

INTRODUCTION: Bilateral talar fracture- dislocations with concomitant medial malleolus fractures are rare and present complex challenges.

CASE REPORT: We present a case study of a 30-year-old male painter who sustained these injuries following a significant fall. The surgical intervention included open reduction and internal fixation with a cannulated cancellous (CC) screw on one side and percutaneous fixation after closed reduction on the other.

CONCLUSION: The patient's patient's three3-year follow-up revealed excellent ankle function and minimal avascular necrosis changes, demonstrating the importance of well-planned delayed therapy over hasty acute procedures. Remarkably, both approaches yielded comparable and favorable outcomes, emphasizing the importance of surgical planning, soft soft-tissue management, and the choice of surgical approach in optimizing outcomes.