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Médecine et chirurgie du pied

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An Uncommon Case of Open Upward Tibiotalar Dislocation without Associated Fracture. A Case Report and Literature Review Volume 31, issue 4, Décembre 2015

Authors

Pure tibiotalar dislocations without fracture associated is an uncommon clinical entity. This injury results most often from high-energy trauma. Predisposing factors can be medial maleollus hypoplasia, lack of coverage of talus, ligamentous laxity, previous sprains or weakness of peroneal muscles. Most displacements are posterior or posteromedial.

We report a case of exceptional open type II Gustillo and Anderson upward tibiotalar dislocation without fracture associated, type IV tibiofibular diastasis according to Edwards and DeLee classification and posterior dislocation of the fibula out of its groove.

Immediate reduction of the dislocation was performed under general anesthesia. The remaining of tibiotalar diastasis lead to use of one syndesmosis screw, followed by immobilizing plaster cast for 6 weeks. After removal of syndesmosis screw, a kinesitherapy protocol was applied. After a follow-up of one year, functional and radiological results were satisfactory.