Huang P J, Fu Y C, Tien Y C, Lin G T, Lin S Y, Cheng Y M, Huang C Y, Huang C K, Hsu C Y
Department of Orthopaedic Surgery, Kaohsiung Medical University, Taiwan.
Kaohsiung J Med Sci. 2000 Apr;16(4):214-8.
Total dislocation of talus from all its surrounding joints (tibiotalar, subtalar and talonavicular) is an extremely rare injury. Because of its rarity, only few case reports can be found in the literature. In the review of the literature, infection and AVN are the most commonly encountered complications that affect the outcome of these severe injuries. Herein we report two cases of open total talar dislocation. Immediate debridement, reduction of the talus, and primary skin closure was done followed by cast immobilization. After more than 2 years follow up, neither infection nor AVN was found. We conclude that reimplantation of the talus is preferable if the wound is relatively clean. Talectomy, or combined with tibiocalcaneal fusion should be reserved for later salvage procedure.
距骨与其周围所有关节（胫距关节、距下关节和距舟关节）完全脱位是一种极其罕见的损伤。由于其罕见性，文献中仅能找到少数病例报告。在文献回顾中，感染和缺血性坏死是影响这些严重损伤预后最常见的并发症。在此我们报告两例开放性距骨完全脱位病例。立即进行清创、距骨复位及一期皮肤缝合，随后进行石膏固定。经过2年多的随访，未发现感染和缺血性坏死。我们得出结论，如果伤口相对清洁，距骨再植术是更可取的。距骨切除术或联合胫跟融合术应留作后期挽救手术。
