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Updated: May 25, 2026

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach

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Closed total talus dislocation: a case report.

Steven Heylen¹, Thierry De Baets, Patricia Verstraete

¹Algemeen Ziekenhuis (AZ) Turnhout, Campus Sint-Elisabeth, Turnhout, Belgium. heylensteven@yahoo.com

Acta Orthopaedica Belgica

|February 8, 2012

Summary

Total talus dislocation, a rare injury from high-energy trauma, can lead to avascular necrosis. This case highlights a closed dislocation requiring open reduction and fixation of associated malleolar fractures.

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The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...

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Area of Science:

Orthopedic Surgery
Trauma Management
Foot and Ankle Surgery

Background:

Total talus dislocation is a severe injury resulting from high-energy trauma, often presenting as an open dislocation.
Closed total talus dislocations are rare and associated with significant risks, including avascular necrosis, posttraumatic osteoarthritis, and infection.
The talus's delicate vascularization relies heavily on surrounding soft tissue attachments, making preservation crucial.

Observation:

A 46-year-old male patient presented with a closed total dislocation of the right talus.
The dislocation was associated with small fractures of the lateral and medial malleoli.
Closed reduction of the talus was unsuccessful.

Findings:

The patient underwent open reduction and internal fixation for the malleolar fractures.

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The case underscores the complexity of closed total talar dislocations, where initial closed reduction may fail.

Surgical intervention was necessary for definitive management of the associated fractures.

Implications:

Preserving soft tissue attachments is crucial for maintaining talar vascularity and minimizing avascular necrosis risk.
This case highlights the need for prompt and appropriate surgical intervention in complex talar dislocations.
Effective management of associated fractures is integral to successful outcomes in total talar dislocations.