Chronic closed talus dislocation: a rare presentation and treatment dilemma

A chronic presentation of closed dorsolateral dislocation of the talus is a rare injury. A 35-year-old woman presented with pain and deformity of the right foot of 6 months' duration. Her medical history was significant for rheumatoid arthritis, for which she was being treated with steroids. Radiographs and computed tomography of the right foot showed dorsolateral talar dislocation with fracture of the medial malleolus. Dislocation of the talus from the tibiotalar, talocalcaneal, and talonavicular joints was indicative of talus dislocation with a fracture of the medial malleolus rather than a fracture-dislocation of the ankle joint. Because of chronic presentation of the injury and an inability to reduce this talus dislocation by closed methods, open total talectomy was performed. At 2-year follow-up, the patient had an AOFAS score of 78. The patient had an obvious limp on the affected limb but managed her activities of daily living well without a shoe raise or brace. Because of the severe varus inversion deformity of the foot preoperatively, the patient was not able to walk. Postoperatively, the deformity was corrected and the patient was able to stand and walk; she was satisfied with the outcome of the surgery.To our knowledge, this is the first report of chronic closed dorsolateral talus dislocation. We recommend that chronic closed isolated dorsolateral talus dislocation can be effectively managed by total talectomy.