title: [Anterior enucleation of a talus with "triple loss of relations". Case report and literature review].
abstract: BACKGROUND
  When the talus loses its triple connection with the ankle mortise, a rare injury occurs in 3-4% of the ankle dislocations; 75% of the injuries are open. A clinical case is presented herein, together with its clinical course and a review of the literature.
  
  
  METHODS
  The case of a male, 52-year-old patient with a left ankle inversion and extension injury is presented. At the time of admission to the emergency room he had triple closed anterior dislocation of the talus. Closed reduction was performed under anesthesia, an acrylic boot was placed and he was followed-up at the outpatient service.
  
  
  RESULTS
  The patient did well and was immobilized initially with an acrylic foot-thigh brace for six weeks; he then wore an acrylic suropodalic brace for 4 weeks and started partial weight bearing with crutches at 10 weeks; total weight bearing with crutches at 12 weeks, and without crutches at 16 weeks. Shortly before this a bone scan was performed and no signs of avascular necrosis were found.
  
  
  CONCLUSIONS
  Triple talar dislocation is a rare injury and its major complication is avascular necrosis and secondary arthrosis that could result in the need for panastragalodesis; the prognosis depends on the timeliness of care, it is a true emergency.
authors.affiliation: Staff de Urgencias, Hospital Médica Sur.
authors.forename: J D
authors.initials: JD
authors.lastname: García-Juárez
authors.forename: A
authors.initials: A
authors.lastname: Tohen-Bienvenu
authors.forename: S
authors.initials: S
authors.lastname: Lozano-Reyes
authors.forename: C
authors.initials: C
authors.lastname: Jiménez-Cabuto
mesh_terms: D000369:Aged, 80 and over; D016512:Ankle Injuries / Q000601:surgery*; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods; D013628:Talus / Q000601:surgery*