Long-term prognosis of tarsal dislocations

Eighty tarsal dislocations treated between 1954 and 1979 are presented. Our of 48 cases reviewed after a mean follow-up time of 7 years, satisfactory results were achieved in 30 (62%). Osteonecrosis of the talus was not recorded whereas necrosis of the navicular developed in 5 patients. Failures are to be related to significant osteoarthritic changes which occurred after a long period particularly in compound injuries with associated fractures of the tarsal bones. Early closed reduction and immobilization in a below-knee cast for 4 weeks is recommended in pure luxation; associated fractures of the talus and navicular require surgical fixation as far as possible. Except in total open dislocation of talus or navicular replacement was by far preferred to removal and primary arthrodesis.