Open talar dislocations without associated fractures

Total dislocation of the talus first reported in 1680. It is a rare injury and without associated fractures is even rarer. Is generally considered to be one of the most disabling ankle injuries and occurs after high energy trauma. The primary goal of our study is the retrospective evaluation of complete talar extrusion without associated fractures and immediate reimplantation.

In the past nine years, nine patients with mean age 31.7 years were admitted to our center with a complete open talar extrusion. The dislocated talus was reduced and held in place with two Steinmann pins placed from the inferior aspect of the calcaneus, through the talus and into the inferior aspect of the tibia. An external fixator was used to stabilize the limb. The mean follow up time was 21.1 months. At the last follow up visit, six patients were evaluated both radiographically and functionally with the AOFAS score.

Six patients were free of complications and the mean AOFAS Ankle-Hindfoot Scale score at the time of the last follow up visit was 82.5. Two patients had an infection, one had avascular necrosis of the talus and one had signs of subtalar joint arthritis. Two patients had to undergo arthrodesis.

It is important to attempt reimplantation of the talus since a good final outcome is to be expected. Even in the case of a catastrophic complication this technique will ensure adequate bone stock for additional surgical procedures.