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Unusual presentation of more common disease/injury
Posterior talar fracture with dislocation of both talo-navicular and subtalar joints: a variant type II of the Sneppens classification
  1. Ilias Galanopoulos1,
  2. Quentin Fogg2,
  3. Neil Ashwood1
  1. 1Department of Trauma and Orthopaedics, Burton Hospitals NHS Foundation Trust, Burton-on-Trent, UK
  2. 2Laboratory of Human Anatomy, University of Glasgow, Glasgow, UK
  1. Correspondence to Ilias Galanopoulos, galanop.ilias{at}gmail.com

A 63-year-old man fell from a ladder, thus causing an axial compression injury to the right ankle. Severe deformity was evident and the ankle could not be reduced by simple manipulation. The skin was tented and appearing critically contused. Radiographs revealed an oblique fracture of the posterior aspect of the talar body with dislocation of both the talo-navicular and subtalar joints, an injury previously not described in the literature. The fracture–dislocation was anatomically reduced within 3 h of presentation and stability achieved with two headless buried compression screws. CT scan confirmed anatomical reduction and the patient remained non-weight bearing in a cast for 6 weeks. One year postoperatively, the patient remains pain-free with no radiological signs of avascular necrosis of the talus. This injury is unique and despite its severity and soft tissue compromise good quality reduction and internal fixation resulted in an excellent clinical outcome.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.