Closed posteromedial total talus and fibula dislocation without fracture

Abstract

Total dislocation of talus is an extremely rare injury. It can be found few reports about dislocations in distal tibiofibular joint without accompanying fibular or medial malleolus fracture. In this case we report about a young patient with high energy trauma who presents a close total talar posteromedial dislocation associated with a fibula posteromedial dislocation. We perform an open reduction temporarily fixed with K wires and finally with 2 trans-syndesmotic screws.

Keywords: Fibula dislocation; Talus dislocation.

Fig. 1

AP and lateral preop view. In this image we can see total talus dislocation and the distal syndesmosis medial dislocation.

Fig. 2

3D CT scan. In this figure we see talar mortise impacted in the calcaneus (medial wall and sustentaculum tali).

Fig. 3

Axial images of CT scan. Complete posteromedial syndesmotic dislocation. The fibula was impacted in the posterior malleolus, which made more difficult to reduce de injury.

Fig. 4

AP an lateral intraop view. Two K wires was inserted to maintain the syndesmosis reduction.

Fig. 5

Trans-syndesmotic screw fixation.