Retrospective analysis of treatment strategies and clinical outcome of isolated talar dislocations.

UNLABELLED

Talar dislocations are rare injuries of the foot and ankle and require quick and decisive diagnostic and therapeutic decisions. Evidence concerning the treatment and outcome of these injuries is sparse. The aim of this study was to analyze all talar dislocations of the last ten years treated in a large German level I trauma center in an effort to add to the experience on these injuries.

METHODS

All patients with a talar dislocation injury were retrospectively included. Medical reports, x-ray and computertomography scans were analyzed for the sex, age, trauma mechanism, and injury classifications as well as for the clinical outcome as measured by the Foot Function Index (FFI).

RESULTS

A total of 18 patients were included in this study: Luxatio pedis cum talo (n = 1), Luxatio tali totalis (n = 3), Luxatio pedis sub talo (n = 14). Analysis of the therapeutic algorithms revealed that only one patient was treated conservatively, the other 17 patients underwent operation. In most cases, stabilization was achieved using an external fixator and if necessary, the subtalar and talonavicular joints were temporarily stabilized using K-wires. The mean follow-up time was 4.25 years (2.05 SD) and the mean FFI-sum score 45.00 (42.26 SD). Two patients required subtalar fusion two years after the injury.

CONCLUSION

Isolated talar dislocations can have a good outcome and be effectively treated in the emergency setting by basic techniqes if neurovasular structures are not injured. Often, these injuries are associated with fractures of adjacent bones which then need complex reconstruction.