title: Treatment of an open medial tibiotalar dislocation with no associated fracture.
abstract: Tibiotalar dislocations without associated fractures are very uncommon in adults, and only a few studies have been published regarding this injury. More than 50% of these dislocations will be posteromedial, with a high incidence of open injuries, and 25% are pure posterior dislocations. In the present report, we discuss our experience and management of a medial tibiotalar dislocation with no associated fracture. In the present case, the patient was brought to the operating room on presentation to our facility and underwent irrigation and debridement with primary closure of his wound. He was immobilized postoperatively. The patient tolerated the operation well and did not sustain any postoperative complications. He was able to regain function of the injured extremity until he was lost to follow-up. Regarding treatment, the surgery should be speedy, gentle to the soft tissue, and with as little implanted material as possible. Although we do not advocate that our management and treatment of this injury become the standard, the present case provides a good example of some of the challenges often encountered when treating these injuries.
authors.affiliation: Department of Orthopaedic Surgery, San Antonio Military Medical Center, San Antonio, TX. Electronic address: Perrybhullar@hotmail.com.
authors.forename: Preetinder S
authors.initials: PS
authors.lastname: Bhullar
authors.affiliation: Department of Orthopaedic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Grant
authors.affiliation: Department of Orthopaedic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX.
authors.forename: Mark
authors.initials: M
authors.lastname: Foreman
authors.affiliation: Department of Orthopaedic Surgery, San Antonio Military Medical Center, San Antonio, TX.
authors.forename: Chad A
authors.initials: CA
authors.lastname: Krueger
mesh_terms: D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000601:surgery; D003646:Debridement; D006801:Humans; D007103:Immobilization; D017746:Joint Capsule / Q000293:injuries / Q000601:surgery; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery*; D017844:Lateral Ligament, Ankle / Q000293:injuries / Q000601:surgery; D008297:Male; D011859:Radiography; D013628:Talus / Q000000981:diagnostic imaging; D013708:Tendon Injuries / Q000601:surgery; D007507:Therapeutic Irrigation; D013977:Tibia / Q000000981:diagnostic imaging; D014947:Wounds and Injuries / Q000601:surgery*; D055815:Young Adult
keywords: injury; medial talar dislocation; open dislocation; talus; tibia; trauma