Open total talus dislocation: case report and review of the literature

An open pure total lateral dislocation of the right talus with extrusion of the whole talar body is reported. Immediately surgical debridement, reduction, and primary closure were accomplished under antibiotic coverage. The ankle was immobilized for 6 weeks, and weight-bearing was restricted for 6 more weeks. Neither avascular necrosis (AVN) of the talus nor infection developed. Both ankle and foot regained full pain-free range of motion at 16 weeks, except for a mild restriction of the last 5 degrees of supination. Four years postinjury, the patient continues in the same preinjury occupation. A thorough review of the literature suggested that (a) immediate closed or open reduction is preferable; (b) if AVN develops, it can be treated in most cases by weight-bearing restrictions; and (c) talectomy, alone or associated with a tibiocalcaneal arthrodesis, should be reserved for an eventual reconstructive procedure, particularly in the event of talus infection.