title: [Current Recommendations for the Therapy of Dislocated Talus Fractures Weber and Marti Type IV - Literature Research].
abstract: IntroductionTalar dislocation fractures of type IV (Marti and Weber) are extremely rare injuries with special challenges to the surgeon and poor results. Due to their low incidence and the sparse literature, it is unclear what is the optimal treatment and how complications can be minimised.Material and MethodsA literature research was carried out using the online medical database "PubMed". The findings of the literature were then applied to a clinical case of type IV talar dislocation fracture (Marti and Weber).ResultsModern osteosynthesis with generous and multiple access paths is to be preferred to the previously prioritised methods of talectomy and arthrodesis. Priority is put on the fastest possible reposition of the fracture, while sparing the soft tissue and the conditions of vascularisation. It can be assumed that with increasing degree of dislocation the risk of necrosis of the talus rises too, but this does not necessarily correlate with the clinical outcome.ConclusionsIn totally dislocated fractures of the talus, the focus is on prompt reposition and sufficient osteosynthetic supply. Nevertheless, frequent complications have to be expected. Medial explantation, which is described in the clinical example and lateral re-implantation of the talar body have never been described before in the literature and were an encouraging development.
authors.affiliation: Klinik für Unfallchirurgie und Orthopädie, Bundeswehrkrankenhaus Ulm.
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Riesner
authors.affiliation: Klinik für Unfallchirurgie und Orthopädie, Bundeswehrkrankenhaus Ulm.
authors.forename: Falk von
authors.initials: FV
authors.lastname: Lübken
authors.affiliation: Klinik für Unfallchirurgie und Orthopädie, Bundeswehrkrankenhaus Ulm.
authors.forename: Sonja
authors.initials: S
authors.lastname: Förster
authors.affiliation: Klinik für Unfallchirurgie und Orthopädie, Bundeswehrkrankenhaus Ulm.
authors.forename: Patricia
authors.initials: P
authors.lastname: Lang
authors.affiliation: Klinik für Unfall- und Wiederherstellungschirurgie der Eberhard-Karls-Universität Tübingen, BG Unfallklinik Tübingen.
authors.forename: Fabian
authors.initials: F
authors.lastname: Stuby
authors.affiliation: Klinik für Unfallchirurgie und Orthopädie, Bundeswehrkrankenhaus Ulm.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Friemert
authors.affiliation: Klinik für Unfallchirurgie und Orthopädie, Bundeswehrkrankenhaus Ulm.
authors.forename: Hans-Georg
authors.initials: HG
authors.lastname: Palm
mesh_terms: D064386:Ankle Fractures / Q000628:therapy*; D019317:Evidence-Based Medicine; D000072039:Fracture Dislocation / Q000628:therapy*; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D005858:Germany; D006801:Humans; D009985:Orthopedics / Q000592:standards*; D017410:Practice Guidelines as Topic; D013628:Talus / Q000293:injuries* / Q000601:surgery*; D014194:Traumatology / Q000592:standards; D016896:Treatment Outcome