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Bilateral Talus and Navicular Fractures accompanied with Unilateral Calcaneal Fracture: A Case Report
1Department of Orthopaedics, Dr Lutfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey.
Malaysian Orthopaedic Journal
|August 17, 2018
Summary
This case study details the surgical treatment of complex bilateral foot fractures sustained from a paragliding accident. The presented protocol achieved excellent functional recovery and return to full activity for the patient.
Area of Science:
- Orthopedic Surgery
- Trauma Management
- Foot and Ankle Reconstruction
Background:
- Simultaneous fractures of the talus, calcaneus, and navicular bones are rare and present significant management challenges.
- A history of high-energy trauma, such as a paragliding accident, can lead to complex, multi-bone foot injuries.
- Optimal surgical strategies for combined talar, calcaneal, and navicular fractures require careful consideration of fracture patterns and joint involvement.
Observation:
- An 18-year-old male presented with a complex pattern of right (coronal shear talar body, anterior calcaneal process, nondisplaced navicular body) and left (displaced navicular body, posteromedial talar process) foot fractures post-paragliding accident.
- Surgical intervention involved anatomical reduction and screw fixation for the right talar body fracture, lateral screw fixation for the left posteromedial talar fragment, and screw fixation with Kirschner wire stabilization for the left navicular fractures.
- The patient demonstrated successful outcomes with satisfactory bilateral foot and ankle function at 36 months post-surgery.
Findings:
- The described surgical protocol effectively addressed the complex, multi-bone foot fractures, achieving anatomical reduction and stable fixation.
- Postoperative Maryland scores indicated good (85) and excellent (90) functional outcomes for the right and left feet, respectively.
- Full return to the patient's pre-injury activity level was achieved within 5 months, highlighting the efficacy of the treatment approach.
Implications:
- This case report proposes a standardized treatment protocol for managing combined talus, navicular, and calcaneal fractures in a single foot injury.
- The findings suggest that prompt and precise surgical management can lead to excellent functional recovery in patients with severe foot trauma.
- This approach may serve as a valuable reference for orthopedic surgeons treating similar complex foot and ankle injuries.
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