Yapici F, Coskun M, Arslan MC, Ulu E, Akman YE. Open reduction of a total talar dislocation: A case report and review of the literature. World J Clin Cases 2019; 7(14): 1850-1856 [PMID: 31417931 DOI: 10.12998/wjcc.v7.i14.1850]
Corresponding Author of This Article
Furkan Yapici, MD, Doctor, Surgeon, Department of Orthopedics and Traumatology, Metin Sabancı Baltalimanı Bone and Joint Diseases Education and Research Hospital, No. 62, Rumeli Hisarı Street, 34470 Baltalimani, Sariyer, Istanbul 34470, Turkey. furkanyapici@hotmail.com
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 26, 2019; 7(14): 1850-1856 Published online Jul 26, 2019. doi: 10.12998/wjcc.v7.i14.1850
Open reduction of a total talar dislocation: A case report and review of the literature
Furkan Yapici, Mehmet Coskun, Muhammet Coskun Arslan, Erman Ulu, Yunus Emre Akman
Furkan Yapici, Mehmet Coskun, Muhammet Coskun Arslan, Erman Ulu, Department of Orthopedics and Traumatology, Metin Sabancı Baltalimanı Bone and Joint Diseases Education and Research Hospital, Istanbul 34470, Turkey
Yunus Emre Akman, Department of Orthopedics and Traumatology, Demiroğlu Bilim University Faculty of Medicine, İstanbul 34387, Turkey
Author contributions: Akman YE and Yapici F were the patient’s orthopedic surgeons, and they reviewed the literature and contributed to drafting the manuscript; Coskun M, Ulu E, and Arslan MC reviewed the literature and drafted the manuscript; Akman YE and Yapici F were responsible for the revision of the manuscript for important intellectual content; all authors gave final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2013), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Furkan Yapici, MD, Doctor, Surgeon, Department of Orthopedics and Traumatology, Metin Sabancı Baltalimanı Bone and Joint Diseases Education and Research Hospital, No. 62, Rumeli Hisarı Street, 34470 Baltalimani, Sariyer, Istanbul 34470, Turkey. furkanyapici@hotmail.com
Telephone: +90-212-3237075Fax: +90-212-3237095
Received: February 2, 2019 Peer-review started: February 11, 2019 First decision: April 18, 2019 Revised: May 2, 2019 Accepted: May 23, 2019 Article in press: May 23, 2019 Published online: July 26, 2019 Processing time: 175 Days and 8.6 Hours
Abstract
BACKGROUND
Total talar dislocation (TTD) is very uncommon for many orthopedic surgeons and emergency/trauma specialists. Scarce cases of TTD have been reported, mainly in the form of open fracture-dislocation injury.
CASE SUMMARY
We report a very rare injury of closed TTD with a follow-up period of 36 mo. Initial closed reduction was not successful because of a fractured highly unstable medial malleolus displaced into the ankle mortise, blocking the relocation of the talus. The patient was able to walk pain-free after the 3rd month of surgery. At the 36-mo follow-up, there were 10 degrees of flexion loss and 10 degrees of extension loss in the tibiotalar joint. Furthermore, 5 degrees of subtalar joint inversion-eversion loss was present.
CONCLUSION
Open reduction should be performed for closed TTDs unless closed reduction is successful.
Core tip: Total talar dislocation occurs as a result of high energy trauma and may lead to permanent disability or amputation. A non-displaced medial malleolus may prevent closed reduction of the talus if it displaces in the ankle mortise. Therefore, open reduction may be needed. Successful results are possible, ensuring that the remaining vascular supply is not harmed. Additionally, a negative Hawkins sign might not indicate talar avascular necrosis with certainty.
