Luxação exposta isolada do astrágalo

Abstract

Total talus dislocation is a rare injury, usually presenting with associated fractures. Open isolated total talar dislocation is less frequent. We report a clinical case of a patient presenting with an open isolated total talar dislocation after fall from height. We proceeded with cleaning, debridement, open reduction and provisory fixation of the talo-navicular and sub-talar joints with Kirschner wires. On follow-up, 5 years post surgery, there are no signs of infection or talar necrosis, and the patient presents only mild limitation of ankle, midfoot and hindfoot motion, not interfering with his everyday activities, and he got back to his previous job. Open isolated total talar dislocation is a challenging situation with an incertain prognosis, with avascular necrosis and infection being the most fearsome consequences. Reimplantation with primary closing of the wound with provisional fixation can allow for an accetable function on the midterm, so that talectomy or tibiocalcaneal arthrodesis can be used only as salvage procedures.