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Talar Dislocation: Is Reimplantation a Safe Procedure?
J Foot Ankle Surg. 2020 May 08 [Online ahead of print]JF

Abstract

Total or complete dislocation of the talus is a triple dislocation of the tibiotalar, talocalcaneal, and talonavicular joints. It is a rare injury and is considered to be 1 of the most disabling ankle injuries. In light of the literature, there is a lack of consensus on their surgical treatment. The primary objective of this retrospective case series was to assess the long-term clinical and radiological outcomes of 5 patients who underwent talar reimplantation for total talar dislocation. From 2005 to 2011, 5 patients were admitted in emergency care unit with a total talar dislocation. The talar dislocation was surgically reduced and stabilized by a temporary internal fixation. Patients were reviewed with a mean follow-up of 60 months (48-70 months). Clinical and radiological evaluations were performed at the last follow-up. Despite 3 opened-dislocation (60%), none had infection. Three patients obtained subnormal biomechanical function with an American Orthopedic Foot and Ankle Score of 60 to 70/100. Two others patients (40%) underwent a secondary ankle arthrodesis because of avascular necrosis of the talus. Signs of necrosis appeared at 15 months and 24 months. Talar reimplantation should be attempted despite the risk of avascular necrosis: restoration of the talus in the ankle maintains normal hindfoot anatomy and preserves bone stock for future function or a subsequent surgical procedure. Patients should be informed of the risk of secondary surgery. Opened-dislocation seems to be a major risk factor of avascular necrosis, and surgeon must take care to keep soft tissues attached.

Authors+Show Affiliations

Orthopedic Surgeon, Orthopaedic and Traumatology Department, University Hospital of Martinica, Martinique, France. Electronic address: mathieu.severyns@hotmail.fr.Orthopedic Surgeon, Orthopaedic and Traumatology Department, University Hospital of Martinica, Martinique, France.Orthopedic Surgeon, Orthopaedic and Traumatology Department, University Hospital of Martinica, Martinique, France.Orthopedic Surgeon, Orthopaedic and Traumatology Department, University Hospital of Martinica, Martinique, France.Orthopedic Surgeon, Orthopaedic and Traumatology Department, University Hospital of Martinica, Martinique, France.Orthopedic Surgeon, Orthopaedic and Traumatology Department, University Hospital of Martinica, Martinique, France.Orthopedic Surgeon, Orthopaedic and Traumatology Department, University Hospiotal of Lariboisière, Paris, France.Orthopedic Surgeon, Orthopaedic and Traumatology Department, University Hospital of Martinica, Martinique, France.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32402620

Citation

Severyns, Mathieu, et al. "Talar Dislocation: Is Reimplantation a Safe Procedure?" The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons, 2020.
Severyns M, Dudouit S, Carret P, et al. Talar Dislocation: Is Reimplantation a Safe Procedure? J Foot Ankle Surg. 2020.
Severyns, M., Dudouit, S., Carret, P., Daoud, W., Lainard, M., Rene-Corail, P., Odri, G. A., & Rouvillain, J. L. (2020). Talar Dislocation: Is Reimplantation a Safe Procedure? The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons. https://doi.org/10.1053/j.jfas.2019.09.042
Severyns M, et al. Talar Dislocation: Is Reimplantation a Safe Procedure. J Foot Ankle Surg. 2020 May 8; PubMed PMID: 32402620.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Talar Dislocation: Is Reimplantation a Safe Procedure? AU - Severyns,Mathieu, AU - Dudouit,Sylvain, AU - Carret,Pierre, AU - Daoud,Wael, AU - Lainard,Morgane, AU - Rene-Corail,Patrick, AU - Odri,Guillaume-Anthony, AU - Rouvillain,Jean-Louis, Y1 - 2020/05/08/ PY - 2019/03/07/received PY - 2019/08/27/revised PY - 2019/09/07/accepted PY - 2020/5/14/entrez PY - 2020/5/14/pubmed PY - 2020/5/14/medline KW - ankle fracture KW - talar avascular necrosis KW - talar dislocation JF - The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons JO - J Foot Ankle Surg N2 - Total or complete dislocation of the talus is a triple dislocation of the tibiotalar, talocalcaneal, and talonavicular joints. It is a rare injury and is considered to be 1 of the most disabling ankle injuries. In light of the literature, there is a lack of consensus on their surgical treatment. The primary objective of this retrospective case series was to assess the long-term clinical and radiological outcomes of 5 patients who underwent talar reimplantation for total talar dislocation. From 2005 to 2011, 5 patients were admitted in emergency care unit with a total talar dislocation. The talar dislocation was surgically reduced and stabilized by a temporary internal fixation. Patients were reviewed with a mean follow-up of 60 months (48-70 months). Clinical and radiological evaluations were performed at the last follow-up. Despite 3 opened-dislocation (60%), none had infection. Three patients obtained subnormal biomechanical function with an American Orthopedic Foot and Ankle Score of 60 to 70/100. Two others patients (40%) underwent a secondary ankle arthrodesis because of avascular necrosis of the talus. Signs of necrosis appeared at 15 months and 24 months. Talar reimplantation should be attempted despite the risk of avascular necrosis: restoration of the talus in the ankle maintains normal hindfoot anatomy and preserves bone stock for future function or a subsequent surgical procedure. Patients should be informed of the risk of secondary surgery. Opened-dislocation seems to be a major risk factor of avascular necrosis, and surgeon must take care to keep soft tissues attached. SN - 1542-2224 UR - https://www.unboundmedicine.com/medline/citation/32402620/Talar_Dislocation:_Is_Reimplantation_a_Safe_Procedure L2 - https://linkinghub.elsevier.com/retrieve/pii/S1067-2516(20)30128-9 DB - PRIME DP - Unbound Medicine ER -
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