Presentation
Jumped over large fence, multiple lower limb deformities, highly intoxicated.
Patient Data
Posterior ankle joint fracture and dislocation with comminuted fracture of the posterior talar body and the anterior tibia. Laterally tilted talus.
Severely comminuted ankle joint fracture and dislocation.
Comminuted intra-articular fracture of the posterior body of talus and a sagittally oriented fracture plane in the mid talar body.
Comminuted intra-articular fracture of the anterior tibia which is hinged against the sagittal oriented mid talar body fracture.
Minor depression fracture of the posterior calcaneal facet.
Multiple intra and periarticular osseous fragments are seen in the ankle and posterior subtalar joint.
Osseous fragments are seen adjacent to the flexor tendon sheaths of the flexor hallucis longus at the tarsal tunnel.
Case Discussion
Fractures of the talar body as the result of very high energy trauma, they have a poor outcome; often associated with osteonecrosis and osteoarthritis. All displaced talar body fractures require surgical intervention to restore the tibiotalar and talocalconeal joints.
Often these fractures will be associated with other injuries, as seen in the case above 1.
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