pantalar dislocation

[Dr. Magdy Anwar]

Dear all

 

        25 years old male sustained falling from height ( about 3 m.) which resulted in left  ankle complete talus dislocation .

Astonishingly enough  the dislocation is a closed injury.

1- What to do and how  ?

2- What is the probable prognosis?

  

Full story and larger images are here:

http://www.madinaortho.com/casweek/talus/talus.htm

إذا كنتَ لا تقرأ إلا ما توافق عليـه فقط، فإنكَ إذاً لن تتعلم أبداً
If my e-mails are annoying u ; plz tell me

 

Dr. Magdy Anwar
Orthopedic Surgeon
King Fahd Hospital - Madinah Munawrah -Saudi Arabia
http://www.madinaortho.com

[Dr.Vishwanath Iyer]

Very unusual injury. The whole intact talus seems to have come out.

If you just distract the ankle with a ring in the lower tibia and a 7/8 ring in the calcaneus, you might be the rare lucky person to be able to reduce it. Invariably it needs open reduction, again with distraction. AV N is almost certain.Best luck.

I am enclosing a case of total posterior dislocation of the body of talus

V M Iyer

2011/11/14 Dr. Magdy Anwar <mag...@gmail.com>

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[Jose M Palomo]

 

    I reported an open total talus dislocation in 1997  [ Palomo-Traver J M et al.  Open Total Talus Dislocation: Case Report and Review of the Literature. J Orthop Trauma 1997 , 11 ( 1 ): 45-49 ]

 

    Treated with immediate surgical debridement, reduction and primary closure, under antibiotic coverage, and immobilized for 6 weeks, followed by 6 more weeks of weight-bearing restriction . Neither avascular necrosis (AVN) of the talus nor infection developed. Both ankle and foot regained full painfree range of motion at 16 weeks, except for a mild restriction of the last 5° of supination. Four years postinjury, the patient continued in the same preinjury occupation.

 

    A thorough review of the literature suggested that AVN and talectomy are not the possible sole fate.

 

    Jose M Palomo, MD

    Castello general Hospital

    Spain

 

From: Dr.Vishwanath Iyer

Sent: Tuesday, November 15, 2011 3:53 PM

To: orth...@googlegroups.com

Subject: Re: [Orthopod] pantalar dislocation

 

Very unusual injury.

AV N is almost certain...

V M Iyer

[kal...@tunet.tn]

Dear Magdy.
I will do a CT before reducing to see how to reduce it closed.
If obligation to open trans medial malleolar The risk of osteonecrosis is high since all the vascular supply seems to be damaged.
Regards
Dr Sofiene Kallel
Tunisia

Envoye par mon BlackBerry Wireless Handheld

---

From: "Dr. Magdy Anwar" <mag...@gmail.com>

Sender: orth...@googlegroups.com

Date: Mon, 14 Nov 2011 10:42:37 +0300

To: <orth...@googlegroups.com>

ReplyTo: orth...@googlegroups.com

Subject: [Orthopod] pantalar dislocation

[trauma msd]

The astragalus bone does not have any vascular supply when dislocated !. 80% of its surface is cartilage and the rest does not have a muscle attached. The immediate reductions is the rule, with each day of delay the necrosis risk is the rule

Regards
Manuel Sotelo
C4R4C4S years from foundation

[trauma msd]

http://www.madinaortho.com/casweek/talus/talus.htm

Dr. Magdy Anwar
Orthopedic Surgeon
King Fahd Hospital - Madinah Munawrah -Saudi Arabia
http://www.madinaortho.com

I get a warning page from Google when I try to open your link. Any idea about this?

Regards
Manuel Sotelo
C4R4C4S years from foundation

 

 

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