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Talar Dislocation: Is Reimplantation a Safe Procedure?
Mathieu Severyns1, Sylvain Dudouit1, Pierre Carret1
1Orthopedic Surgeon, Orthopaedic and Traumatology Department, University Hospital of Martinica, Martinique, France.
Total talar dislocation is a severe ankle injury. Talar reimplantation offers potential benefits despite avascular necrosis risks, preserving anatomy for future procedures.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Ankle Biomechanics
Background:
- Total talar dislocation is a rare and disabling ankle injury.
- Surgical treatment lacks consensus in current literature.
- This study evaluates talar reimplantation outcomes for total talar dislocation.
Observation:
- Five patients with total talar dislocation underwent reimplantation.
- Mean follow-up was 60 months.
- Sixty percent of dislocations were open injuries, with no infections.
Findings:
- Three patients (60%) achieved subnormal function (60-70/100 on AOFAS score).
- Two patients (40%) required secondary ankle arthrodesis due to avascular necrosis of the talus.
- Avascular necrosis signs appeared at 15 and 24 months post-surgery.
Implications:
- Talar reimplantation should be considered to maintain hindfoot anatomy and bone stock.
- Open dislocation is a risk factor for avascular necrosis, requiring careful soft tissue management.
- Patients must be informed about the risk of secondary surgery and avascular necrosis.
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