RESUMO
INTRODUCTION: Talus fracture is an uncommon fracture that can be encountered on day- to- day basis. However, it is the 2nd most common tarsal bone to get fractured after calcaneum and accounts for approximately 1% of all fractures around foot and ankle. The anastomotic ring around the talar neck is highly likely to get damaged at the time of the fracture, which, in turn, hampers the blood supply to the body of talus. As a result, the bone healing is delayed and the integrity of the healed fracture is poor which leads to poor functional outcome. Almost 39% cases are missed during the initial evaluation, and talus fracture accounts for almost 50% of all the missed injuries (6-8). A high level of clinical suspicion is required to avoid missing such injuries. CASE REPORT: A 26-year-old male presented to the outpatient department with chief complaint of pain over the left foot while walking for past 6 months. There was a history of significant trauma to the foot 6 months back (fall from 12 feet) for which he sought medical advice and was managed with analgesics and rest for a couple of weeks. He presented to us 6 months later with chronic, dull aching, and continuous pain which aggravates while walking and standing. The diagnosis of the non-union fracture neck of talus was made after radiology and was managed by open reduction and internal fixation with cannulated cancellous screws along with contralateral iliac crest cancellous bone grafting. CONCLUSION: Delay in diagnosing such injuries accelerates the vascular compromise, delays timely intervention, and ultimately leads to increased morbidity.
RESUMO
INTRODUCTION: Combined talar body fracture with a medial malleolar fracture is rare in literature. CASE PRESENTATION: A 30-year-old female presented to our hospital with complaints of pain and swelling over the right ankle joint with difficulty in bearing weight following a motor vehicle accident. Investigation showed talar body fracture of type 2 Sneppen (classification) with an ipsilateral medial malleolar fracture. Fractured talus was openly reduced with the help of reduction clamp and appropriate sized Herbert screw applied to hold the reduction. The medial malleolar fracture was fixed with an appropriate-sized cannulated cancellous screw after confirming satisfactory reduction. The patient was followed up for wound complications, AVN changes, early osteoarthritic changes, and functional outcome. CONCLUSION: The combined talar body fracture, ankle dislocation with a medial malleolar fracture, should be managed; as soon as, a diagnosis is made to get a good functional outcome, even though the incidence of skin complication, AVN risk, and post-traumatic ankle arthritis could not be predicted even though it was absent in our case.
