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Closed Pantalar Dislocation With Checkrein Deformity: A Unique Case Report and Literature Review
1From the Southeast Permanente Foot and Ankle Trauma and Reconstructive Surgical Fellowship, Atlanta, GA (Speer and Dr. Pike); and the Emerald Coast Foot and Ankle Center, Pensacola, FL (Speer).
Abstract:
Closed pantalar dislocations are a rare variant of an uncommon injury. Pantalar dislocations are typically caused by high-energy trauma resulting in an open injury with associated fracture of the articulating bones. Given its obscurity, the literature on closed pantalar dislocations is scarce, and no standard treatment protocol has been accepted. This case report chronicles the treatment and outcome of a 29-year-old man who presented with a checkrein deformity of all digits after a closed pantalar dislocation with 6-month follow-up. A comprehensive literature review found 28 articles representing 39 patients with closed pantalar dislocations without talar neck or body fractures. Roughly equal numbers of closed and open reduction techniques were performed with avascular necrosis occurring in 7 of 36 patients. Although outcome measures and follow-up were variable, what can be considered a suitable outcome was seen in approximately 83% of patients, with only 3 of 35 requiring a secondary operation. Long-term studies with well-defined outcome measures are needed to adequately predict the prognosis of this rare injury and efficacy of treatment protocols.

