[Anterior enucleation of a talus with "triple loss of relations". Case report and literature review]. / Enucleación anterior del astrágalo "pérdida triple de su relación". Presentación de un caso.

INTRODUCTION: When the talus loses its triple connection with the ankle mortise, a rare injury occurs in 3-4% of the ankle dislocations; 75% of the injuries are open. A clinical case is presented herein, together with its clinical course and a review of the literature. CLINICAL CASE: The case of a male, 52-year-old patient with a left ankle inversion and extension injury is presented. At the time of admission to the emergency room he had triple closed anterior dislocation of the talus. Closed reduction was performed under anesthesia, an acrylic boot was placed and he was followed-up at the outpatient service. RESULTS: The patient did well and was immobilized initially with an acrylic foot-thigh brace for six weeks; he then wore an acrylic suropodalic brace for 4 weeks and started partial weight bearing with crutches at 10 weeks; total weight bearing with crutches at 12 weeks, and without crutches at 16 weeks. Shortly before this a bone scan was performed and no signs of avascular necrosis were found. CONCLUSIONS: Triple talar dislocation is a rare injury and its major complication is avascular necrosis and secondary arthrosis that could result in the need for panastragalodesis; the prognosis depends on the timeliness of care, it is a true emergency.