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Summary
Closed reduction of irreducible tarsometatarsal fracture-dislocations is often prevented by specific tissue or bone fragment interpositions. Open reduction is a viable surgical option for these complex foot injuries, restoring function.
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Trauma
- Radiology
Background:
- Tarsometatarsal fracture-dislocations are complex injuries.
- Closed manipulative reduction can be challenging due to specific interpositional impediments.
Observation:
- Three primary mechanisms hinder closed reduction: anterior tibialis tendon interposition, medial cuneiform-first metatarsal incongruity, and fracture fragment impaction in the second metatarsal-intermediate cuneiform joint.
- An irreducible tarsometatarsal fracture-dislocation in a 25-year-old male presented a clinical challenge.
Findings:
- Open reduction successfully achieved anatomic reduction in the presented case.
- The patient regained normal passive range of ankle motion postoperatively.
Implications:
- Understanding these irreducible mechanisms is crucial for surgical planning in tarsometatarsal injuries.
- Open reduction offers a successful treatment pathway for irreducible fracture-dislocations, leading to functional recovery.