Fracture-dislocation of the talus in the pediatric patient. An unusual injury

1991 ◽  
Vol 81 (9) ◽  
pp. 495-498 ◽  
Author(s):  
JM Stutz ◽  
JM Karlin ◽  
N Daly
Keyword(s):  
Pediatric Patient ◽  
Closed Reduction ◽  
Subtalar Joint ◽  
Fracture Dislocation ◽  
Joint Dislocation ◽  
Subtalar Dislocation ◽  
Posterior Process ◽  
Fracture Dislocations ◽  
Unusual Injury

Subtalar fracture-dislocations in children are unusual, perhaps because of the greater elasticity of bone in children. The authors have presented a case of medial subtalar dislocation in a 13-year-old boy, accompanied by a rare fracture of the entire posterior process of the talus. This particular fracture has not been previously reported in association with a subtalar joint dislocation, nor has it been reported in a child. The patient was treated successfully by closed reduction of both the dislocation and the fractures.

scholarly journals Isolated Medial Subtalar Joint Dislocation during Soccer (Football) Game: A Case Report and Review of the Literature

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Fekhaoui MR ◽  
◽  
Bassir R A ◽  
Mekkaoui J ◽  
Boufettal M ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Closed Reduction ◽  
Subtalar Joint ◽  
Full Range ◽  
Joint Stiffness ◽  
Young Male ◽  
High Energy ◽  
Joint Dislocation ◽  
Subtalar Dislocation ◽  
First Choice

Ankles injuries are common in sports such as football and soccer and one of the most serious and most rare is the subtalar dislocation. This injury is rare, touches young male patients and usually associated to fractures of the talus, the malleoli or the fifth metatarsal. Usually, this injury occurs in high-energy trauma, but it is very rare in sports injuries. Here we present the case of a 36-year-old male with an isolated Medial Subtalar Joint Dislocation after a severe tackle in a football (soccer) game. We performed a closed reduction under general anesthesia, and then a short-leg cast was applied for 4 weeks, followed by active and passive range of motion. At one-year follow up from trauma, the patient had a pain-free ankle with active full range of motion. For isolated medial subtalar dislocation occurring during sports activities, the first choice is the conservative treatment: Immediate closed reduction needs to be achieved followed by a short immobilization. Active/passive range of motion need to be started early to avoid joint stiffness.

Fracture of the Entire Posterior Process of Talus Associated with Subtalar Dislocation: A Case Report

1996 ◽  
Vol 17 (4) ◽  
pp. 226-229 ◽  
Author(s):  
Yeung-Jen Chen ◽  
Robert Wen-Wei Hsu ◽  
Hsin-Nung Shih ◽  
Tsung-Jen Huang
Keyword(s):  
Case Report ◽  
Closed Reduction ◽  
Subtalar Joint ◽  
Traffic Accident ◽  
Talus Fracture ◽  
Posterior Portion ◽  
Subtalar Dislocation ◽  
Posterior Process ◽  
And Inversion

This is a case report of a 52-year-old woman who sustained a medial subtalar dislocation with fracture of the posterior process of the talus in a traffic accident. After closed reduction of the subtalar dislocation, tomography demonstrated that the talus fracture involved the entire posterior process and the posterior portion of the talar body. The fracture of the talus was treated with an open reduction and miniscrew fixation. At follow-up examination 32 months later, the functional and radiographic results were graded as good. The proposed mechanism of this case was a forced plantarflexion and inversion acting simultaneously on the subtalar joint. This was different from an isolated medial subtalar dislocation, which was caused by an inversion.

Pseudo Os Trigonum Sign: Missed Posteromedial Talar Facet Fracture

2003 ◽  
Vol 24 (8) ◽  
pp. 642-649 ◽  
Author(s):  
A. Ylenia Giuffrida ◽  
Sheldon S. Lin ◽  
Nicholas Abidi ◽  
Wayne Berberian ◽  
Avril Berkman ◽  
...  
Keyword(s):  
Ct Scan ◽  
Subtalar Joint ◽  
Articular Surface ◽  
Cast Immobilization ◽  
Rare Injury ◽  
Joint Dislocation ◽  
Os Trigonum ◽  
Subtalar Dislocation ◽  
Subtalar Arthritis ◽  
Facet Fracture

Background: Posteromedial talar facet fracture (PMTFF) is a rare injury, sparsely reported in the literature. This article proposes that PMTFF is often left undiagnosed by orthopaedic surgeons and suggests the routine application of advanced radiographic studies (i.e., CT scan) in the recognition of PMTFF. It also evaluates nonoperative management of PMTFF. Methods: After obtaining Institutional Review Board approval, the medical records over a 5-year period (1997–2001) were retrospectively reviewed from the foot and ankle service of a level 1 trauma center, identifying all cases of PMTFF. Charts were reviewed for relevant data. Results of treatment were assessed during follow-up physical examination. Results: Six cases of PMTFF were identified over a 5-year period. All injuries were associated with medial subtalar joint dislocation. Four of six (66%) patients were not initially diagnosed with PMTFF, but instead misdiagnosed as an os trigonum. The remaining two patients had an established diagnosis of PMTFF at the time of initial treatment. All had short leg cast immobilization for medial subtalar dislocation. CT evaluation yielded additional diagnoses in all six patients. All six patients showed a PMTFF. Five patients (83%) revealed persistent subtalar joint subluxation. Five of six (83%) patients required at least one additional procedure as a result of an undiagnosed or nonoperatively treated PMTFF. Four patients underwent subtalar joint fusion, and one patient underwent tibiotalar calcaneal fusion secondary to concomitant ankle/subtalar arthritis. The patient who did not undergo recommended fusion continued to be symptomatic. Conclusions: Diagnosis of PMTFF necessitates a heightened clinical suspicion, especially when a medial subtalar joint dislocation is present. Proper imaging studies, such as coronal CT scan, should be performed after any subtalar dislocation. Timely treatment, in the form of open reduction and internal fixation for large fragments involving the articular surface or surgical excision for smaller fragments, is recommended in order to restore proper anatomy and function of the subtalar joint. This study verifies the significant morbidity associated with an undiagnosed or nonoperatively treated PMTFF.

scholarly journals Nonoperative Treatment of Ulnar Carpometacarpal Fracture–Dislocations

2019 ◽  
Vol 09 (02) ◽  
pp. 160-163
Author(s):  
Isidro Jiménez ◽  
Juan Sánchez-Hernández ◽  
Dimosthenis Kiimetoglou
Keyword(s):  
Closed Reduction ◽  
Case Reports ◽  
Nonoperative Treatment ◽  
Fracture Dislocation ◽  
Joint Stability ◽  
Joint Dislocations ◽  
Secondary Dislocation ◽  
Fracture Dislocations ◽  
Cmc Joint

Abstract Background Ulnar carpometacarpal (CMC) joint dislocations and fracture–dislocations are uncommon injuries that are often overlooked. Most authors advocate surgical stabilization in order to prevent a secondary dislocation assuming that these injuries are inherently unstable. Case Description This is a series of eight ulnar CMC joint dislocations and fracture–dislocations treated by closed reduction and splint immobilization after assessing the joint stability. Mean follow-up was 30.2 months, and minimum follow-up was 12 months. Satisfactory results were obtained in range of motion, grip strength, pain, DASH (Disabilities of the Arm, Shoulder and Hand) questionnaire, and time to return to working activities. In the same period, the closed reduction and cast failed two (20%) cases that were referred for surgery. Literature Review There is little published literature on the nonoperative treatment of these injuries. Most of them are isolated case reports, whereas the largest series reports four cases. All of them have reported satisfactory results. Clinical Relevance Based on our results, we believe that if the diagnosis of an ulnar CMC joint dislocation or fracture–dislocation is early accomplished and a concentric and stable reduction is initially achieved, the nonoperative treatment may be a successful option to take into account but requiring a close follow-up for the first week.

Subtalar Joint Dislocations

1995 ◽  
Vol 16 (12) ◽  
pp. 803-808 ◽  
Author(s):  
Donald R. Bohay ◽  
Arthur Manoli
Keyword(s):  
Current Literature ◽  
Closed Reduction ◽  
Subtalar Joint ◽  
Joint Stiffness ◽  
Cast Immobilization ◽  
Joint Dislocation ◽  
Posttraumatic Arthrosis ◽  
Articular Fractures ◽  
Joint Dislocations ◽  
Short Period

Dislocations of the subtalar joint are rare injuries. The anatomy, pathophysiology, treatment, and prognosis of subtalar joint dislocations have been well described in the literature. The purpose of this paper is to review the current literature on subtalar joint dislocations, as well as outline those aspects of the anatomy, pathomechanics, and treatment pertinent to care of the patient with subtalar joint dislocation. In addition, complications and obstacles to reduction are described. Subtalar joint dislocations, although not common, have increased in frequency over the last decade. Generally, they can be treated successfully with closed reduction and a short period of cast immobilization. The majority of patients will suffer some disability with subtalar joint stiffness the primary complaint. Associated intra-articular fractures increase the risk of posttraumatic arthrosis.

scholarly journals Closed reduction and percutaneous intramedullary pinning of displaced radial neck fracture in a 12 years old child: reduction technique and outcome

2020 ◽  
Vol 6 (4) ◽  
pp. 854
Author(s):  
Sunil Chandrashekar ◽  
Jagadish Laxmansa Katwa ◽  
Amlan Singh
Keyword(s):  
Closed Reduction ◽  
Forearm Fracture ◽  
Kirschner Wire ◽  
Fracture Dislocation ◽  
Radial Neck Fracture ◽  
Radial Neck ◽  
Radial Neck Fractures ◽  
Intramedullary Pinning ◽  
Fracture Dislocations ◽  
Neck Fracture

<p>Fracture of the radial neck are uncommon injuries in the pediatric age group. In children, they may present as radial neck fractures, a component of forearm fracture-dislocations, or as isolated fracture-dislocations. Most of the displaced radial neck fractures with more than 30<sup>0</sup> angulations (Judet type III and IV fractures) should be surgically treated. An unusual variant of radial neck fracture with dislocation of the radial head to the radial side without associated nerve injury. The fracture-dislocation was fixed with closed reduction and Kirschner wire under image intensifier. The patient is being followed up for 6 months. Operative treatment with closed reduction and intramedullary pinning has better correction of angulation and rotation compared to closed reduction techniques with angulation of 30<sup>0</sup> or more with 10<sup>0</sup> of rotation. we achieved a supination of 80<sup>0</sup> and a pronation of 50<sup>0</sup>.</p>

scholarly journals Closed medial subtalar dislocation: case report and review of the literature

2019 ◽  
Vol 5 (4) ◽  
pp. 732
Author(s):  
Everisto A. Opondo
Keyword(s):  
Subtalar Joint ◽  
High Energy ◽  
Review Of The Literature ◽  
Osteochondral Fracture ◽  
Joint Dislocation ◽  
Wound Debridement ◽  
Subtalar Dislocation ◽  
Joint Dislocations ◽  
Excellent Functional Outcome

A rare case of medial subtalar dislocation is presented and the literature concerning this injury is reviewed. Subtalar joint dislocations are rare and often the result of a high-energy trauma. These talar dislocations represent 1%-2% of all dislocations. A case of uncomplicated medial subtalar joint dislocation managed by closed reduction under anaesthesia with excellent functional outcome is presented. In cases of open subtalar joint dislocation immediate reduction, wound debridement and if necessary (external) stabilization is critical. Up to fifty percent of patients suffering complicated injury are at risk of developing complications such as avascular necrosis of the talus. Other long-term sequelae include osteochondral fracture and subtalar joint instability.

Lateral subtalar dislocation. A literature review and unusual case report

1992 ◽  
Vol 82 (3) ◽  
pp. 162-166 ◽  
Author(s):  
CL Sands ◽  
N Daly ◽  
JM Karlin ◽  
BL Scurran
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Subtalar Joint ◽  
Unusual Case ◽  
Long Term Results ◽  
Review Of The Literature ◽  
Joint Dislocation ◽  
Subtalar Dislocation ◽  
Unusual Case Report

An unusual case of suspected lateral subtalar joint dislocation was reported. A review of the literature found that medial dislocations were reported four times more frequently than lateral dislocations. Half of the cases of subtalar dislocation reviewed here described associated fractures, the incidence of which was higher in lateral dislocations. In both types of dislocations examined, almost half were reduced nonoperatively. In most cases, long-term results of repair of these injuries were considered favorable.

Temporizing External Fixation vs Splinting Following Ankle Fracture Dislocation

2019 ◽  
Vol 41 (2) ◽  
pp. 177-182
Author(s):  
Richard A. Wawrose ◽  
Leonid S. Grossman ◽  
Matthew Tagliaferro ◽  
Peter A. Siska ◽  
Gele B. Moloney ◽  
...  
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Closed Reduction ◽  
Ankle Fracture ◽  
Skin Necrosis ◽  
Fracture Dislocation ◽  
Level Of Evidence ◽  
Increased Risk ◽  
Loss Of Reduction ◽  
Fracture Dislocations

Background: Closed reduction and splinting followed by outpatient management is standard of care for temporizing most ankle fractures. However, ankle fracture-dislocation potentially warrants a different approach based on the propensity for loss of reduction. The purpose of this study was to determine the rate of complications associated with closed reduction and splinting of unstable ankle fracture-dislocations. Further, we sought to determine the efficacy of immediate external fixation as an alternative to splinting in cases too swollen for acute operation. Methods: This retrospective chart review analyzed all ankle-fracture dislocations that came through a large health care system from 2008 to 2018. Patients managed with acute open reduction internal fixation (ORIF) and open fractures were excluded. In patients managed late, the cohorts were divided into those temporized with closed reduction/splinting vs external fixation. Reduction quality and splint technique were additionally assessed in splinted patients. A total of 354 closed ankle fracture-dislocations were identified: 298 patients (84%) underwent ORIF within 48 hours and were excluded; 28 (15 female/13 male, average age 46.8 years) were placed in an external fixator and 28 (22 female/6 male, average age 57.2 years) were reduced, splinted, and discharged. Results: At follow-up, 14 of the patients (50%) in the splint group developed loss of reduction and 5 of these patients (17.6%) developed anteromedial skin necrosis from skin tenting. None of the patients in the ex-fix group developed loss of reduction or skin necrosis. The rate of redislocation and the rate of development of skin necrosis was statistically higher in cases temporized with a splint versus an external fixator ( P < .01 and P = .05, respectively). Conclusion: We found that in ankle fracture-dislocations not treated with acute ORIF, splint immobilization was associated with an increased risk of complications, including redislocation and skin necrosis, when compared to a temporizing external fixator. Level of Evidence: Level III, retrospective comparative study.

scholarly journals Irreducible Volar DRUJ Dislocation with Distal Radius Fracture Dislocation

2019 ◽  
Vol 09 (02) ◽  
pp. 156-159
Author(s):  
Matthew T. Gulbrandsen ◽  
Jill G. Putnam ◽  
J. Tracy Watson ◽  
Michael D. McKee
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Closed Reduction ◽  
Open Reduction ◽  
Case Reports ◽  
Distal Radioulnar Joint ◽  
Fracture Dislocation ◽  
Radius Fracture ◽  
Level Of Activity ◽  
Fracture Dislocations

Abstract Background Volar dislocations of the distal radioulnar joint (DRUJ) are rare and often missed during initial evaluation. Chronic dislocations and disability can occur when DRUJ dislocations are unrecognized and not reduced. DRUJ dislocations often occur with other wrist injuries, which may complicate reduction. Closed reduction can fail to reduce DRUJ dislocations, in which case open reduction is necessary. Case Description This case describes a patient who had a volar dislocation of the DRUJ with an associated dorsal distal radius fracture dislocation. Initial attempts at closed reduction were unsuccessful which prompted surgical intervention. After open reduction and internal fixation of the distal radius fracture dislocation, closed reduction of the DRUJ remained unsuccessful. This prompted an open reduction of the DRUJ. Surgical exposure demonstrated that the extensor carpi ulnaris and the distal radius had prevented closed reduction of the DRUJ. Postoperatively, a splint was placed with the wrist in supination. The patient followed-up at the 2- and 4-month intervals with persistent subluxation. However, the patient also reported minimal pain and the ability to return to work and previous level of activity. Literature Review Current literature regarding irreducible volar DRUJ dislocations with distal radius fracture dislocations includes sparse case reports, which are reviewed in this report. Clinical Relevance This case illustrates successful treatment for an uncommon volar DRUJ dislocation associated with a dorsal distal radius fracture dislocation and can be utilized to help guide future treatment of similar complex cases.

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