Open Fracture Dislocation of the Talus With Partial Talar Extrusion: A Case Report.

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Vascular Surgery

Background:

• Open talar fracture-dislocations are severe injuries often involving neurovascular compromise.
• Posterior tibial artery injury is a rare but serious complication associated with talar fractures.

Observation:

• A case of Gustilo-Anderson type IIIA open talar fracture-dislocation with posterior tibial artery injury is presented.
• Initial management included limb alignment, splinting, and posterior tibial artery ligation.
• Surgical fixation of the talar neck fracture was performed using Kirschner wires (K-wires).

Findings:

• Despite successful fracture fixation and rehabilitation, the patient developed avascular necrosis (AVN) of the talus at nine months post-injury.
• The patient achieved good ankle range of motion and a congruent ankle joint initially.

Implications:

• This case underscores the significant risk of talus AVN following open talar fracture-dislocation.
• Preserving the extruded talus and achieving anatomical reduction are vital for maintaining ankle alignment.
• Anatomical alignment is critical for potential future ankle arthrodesis in cases of AVN.