Total Closed Talar Dislocation without Ankle Fracture: A Case Report

We report a case of a 61-year-old female who presented to the emergency room after a fall from stairs. A total closed talar dislocation without talus or ankle fracture was diagnosed. The treating surgeon indicated an open reduction after an unsuccessful attempt at closed reduction. After six months of follow-up, the patient reported mild pain and partial weight-bearing with no discomfort; however, signs of talar avascular necrosis were present on magnetic resonance images and CT scans.

Keywords
ankle fractures/diagnosis; joint dislocations; subtalar joint

Authorship

Rubén Daniel Arellano Address for correspondence Rubén Daniel Arellano Pérez Vertti, Dr., Universidad Autónoma de Coahuila, Facultad de Medicina Torreón, Avenida Morelos 900, Oriente, 27000, Torreón, Coahuila, México (e-mail: arellanodaniel1969@gmail.com).

Facultad de Medicina Torreón, Universidad Autónoma de Coahuila, Torreón Coahuila, MexicoUniversidad Autónoma de CoahuilaMexicoTorreón Coahuila, MexicoFacultad de Medicina Torreón, Universidad Autónoma de Coahuila, Torreón Coahuila, Mexico

https://orcid.org/0000-0001-9283-6259

Daniel Orlando Arellano

https://orcid.org/0000-0002-9577-2331

Diego Fernando Arellano

https://orcid.org/0000-0002-9563-1504

José Ángel Becerra

https://orcid.org/0000-0001-7467-7581

José Arturo Ramírez

https://orcid.org/0000-0003-2607-5310

Address for correspondence Rubén Daniel Arellano Pérez Vertti, Dr., Universidad Autónoma de Coahuila, Facultad de Medicina Torreón, Avenida Morelos 900, Oriente, 27000, Torreón, Coahuila, México (e-mail: arellanodaniel1969@gmail.com).

Conflict of Interests

The authors have no conflict of interests to declare.

SCIMAGO INSTITUTIONS RANKINGS

Figures

Figures (5)

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Fig. 1
Clinical image showing edema of the ankle and skin lesion.

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Fig. 2
Plain radiographs and computed tomography scans showing total talar dislocation. (A,B) The white arrows point to the subtalar joint area due to rotation of the talus. The red arrow points to the fracture at the base of the fifth metatarsal bone.

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Fig. 3
(A-C) Operative images. The surgical forceps points to the subtalar joint area and relocation of the talus. (D-F) Postoperative radiographs. Notice the osteochondral fracture on the talar dome (red arrow).

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Fig. 4
Radiographs revealed the Hawkins sign six weeks postoperatively (red arrow). No sclerosis or bone collapse of the talar dome was observed.

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Fig. 5
(A,B) Computed tomography scans on Sagittal and coronal views performed six months postoperatively. Osteochondral fracture of the talar dome is observed (white arrows). (C-E) T2-weighted sagittal magnetic resonance imaging scan performed six months postoperatively, which shows a zone of high signal intensity in the talar dome (red arrow). Sagittal and coronal T2-weighted magnetic resonance imaging scans. No evidence of avascular necrosis or intra-articular free fragments were found.

Fig. 1 Clinical image showing edema of the ankle and skin lesion.

Fig. 2 Plain radiographs and computed tomography scans showing total talar dislocation. (A,B) The white arrows point to the subtalar joint area due to rotation of the talus. The red arrow points to the fracture at the base of the fifth metatarsal bone.

Fig. 3 (A-C) Operative images. The surgical forceps points to the subtalar joint area and relocation of the talus. (D-F) Postoperative radiographs. Notice the osteochondral fracture on the talar dome (red arrow).

Fig. 4 Radiographs revealed the Hawkins sign six weeks postoperatively (red arrow). No sclerosis or bone collapse of the talar dome was observed.

Fig. 5 (A,B) Computed tomography scans on Sagittal and coronal views performed six months postoperatively. Osteochondral fracture of the talar dome is observed (white arrows). (C-E) T2-weighted sagittal magnetic resonance imaging scan performed six months postoperatively, which shows a zone of high signal intensity in the talar dome (red arrow). Sagittal and coronal T2-weighted magnetic resonance imaging scans. No evidence of avascular necrosis or intra-articular free fragments were found.

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Total Closed Talar Dislocation without Ankle Fracture: A Case Report

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[1] Address for correspondence Rubén Daniel Arellano Pérez Vertti, Dr., Universidad Autónoma de Coahuila, Facultad de Medicina Torreón, Avenida Morelos 900, Oriente, 27000, Torreón, Coahuila, México (e-mail: arellanodaniel1969@gmail.com).