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Related Experiment Videos

Complications and Functional Outcomes After Pantalar Dislocation.

Kaeleen A Boden1, Douglas S Weinberg, Heather A Vallier

  • 11Department of Orthopaedic Surgery, MetroHealth Medical Center, Cleveland, Ohio.

The Journal of Bone and Joint Surgery. American Volume
|April 19, 2017
PubMed
Summary

Pantalar dislocations without talar fracture are rare but lead to frequent pain and functional limitations. While deep infection is avoidable, osteonecrosis is common, impacting long-term outcomes.

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Area of Science:

  • Orthopedic Surgery
  • Traumatology
  • Foot and Ankle Surgery

Background:

  • Pantalar dislocations without talar fracture are rare injuries.
  • These injuries carry significant risks of complications like infection, osteonecrosis, and posttraumatic arthrosis.
  • Limited data exists on the long-term functional outcomes following such dislocations.

Purpose of the Study:

  • To evaluate the complications and functional outcomes of pantalar dislocations without associated talar fracture.
  • To assess the incidence of infection, osteonecrosis, and posttraumatic arthrosis.
  • To determine patient-reported outcomes including pain, function, and return to employment.

Main Methods:

  • Retrospective review of 19 patients with pantalar dislocations without talar fracture (14 open, 5 closed).

Related Experiment Videos

  • Surgical management included debridement for open injuries, open or closed reduction, and fixation with Kirschner wires, external fixation, or both.
  • Complications, pain, range of motion, and secondary procedures were recorded. Functional outcomes were assessed using the Foot Function Index (FFI) and Musculoskeletal Function Assessment (MFA) after a minimum of 1 year.

    • Main Results:

    • No deep infections occurred following urgent surgical debridement and talar reimplantation.
    • Osteonecrosis developed in 88% of patients with adequate follow-up, though talar dome collapse was uncommon (12.5%).
    • Posttraumatic arthrosis affected 44% of patients. At a mean of 5.2 years post-injury, 58% of patients completed outcome surveys, reporting significant functional limitations (MFA: 30.3, FFI: 25.3) and frequent pain (88%).

    Conclusions:

    • Urgent surgical intervention for pantalar dislocations without talar fracture can prevent deep infection.
    • Osteonecrosis is a frequent complication, but talar collapse is not inevitable.
    • Persistent pain and functional deficits are common long-term sequelae, necessitating comprehensive patient management and realistic outcome expectations.