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Management of Total Talar Dislocation Following High-Impact Injury: A Case Study

This case presents a 30-year-old otherwise healthy male who sustained a total talar dislocation after a fall from 3 meters in a construction accident. Examination revealed significant deformity and delayed capillary refill in the left foot, with tenderness around the right heel. Closed reduction was performed under anesthesia, aided by calcaneal traction. Post-reduction, we discuss testing for stability, considering if transfixation of the talus is necessary, and review the timeline for potential avascular necrosis development.

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Management of Total Talar Dislocation Following High-Impact Injury: A Case Study

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  1. Case PresentationTotal Talar DislocationTTD BASSAM ALAHMADI Orthopedic Resident R5 King Fahad Hospital Madina KSA

  2. TTD History: • 30 yrs old, otherwise healthy man. • Presented with hx of FD 3-meters height in a construction hole. • Axial load to the Rt ankle • Twisting inj. to the Lt ankle

  3. TTD P/E: ATLS protocol Lt foot> • Deformity with marked prominence anterior the left malleolus. • No open wounds. • Signs of skin compromise. • Delayed capillary refill. • Neurologically is intact. Rt foot> Tenderness and swelling around the heel.

  4. TTD

  5. TTD

  6. TTD Treatment Closed reduction under anaesthesia with aid of calcaneal traction.

  7. TTD Following closed reduction , how can we test for stability? Should we transfix the talus in a stable one? After how long an AVN can be developed?

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