Management of Neglected Medial Peritalar Dislocations: A Preliminary Report with Clinical and Radiological Analysis of 10 Cases
Gurunath S Wachche, Sunil Handralmath, Prashant Dhamoji
Neglected medial peritalar dislocations, Open reduction and transarticular fixation, Subtalar joint, Talonavicular joint
Citation Information :
Wachche GS, Handralmath S, Dhamoji P. Management of Neglected Medial Peritalar Dislocations: A Preliminary Report with Clinical and Radiological Analysis of 10 Cases. J Foot Ankle Surg Asia-Pacific 2022; 9 (2):81-85.
Aim and objective: To study the functional outcome of neglected medial peritalar dislocations treated with open reduction and k-wire fixation and assess the clinical and radiological outcome of these neglected cases.
Materials and methods: A prospective study was performed on 10 patients between June 2016 and July 2020. All the cases were treated with open reduction and internal fixation with k-wire fixation in the Department of Orthopaedics and private setup. We graded these injuries according to the AOFAS ankle hindfoot scale.
Results: In our study, all the patients had closed injury and presented to us between 4 weeks to 8 weeks after injury without taking any primary treatment. The mean age group was 21–58 years of age with male predominance (60%). Road traffic accident (RTA) is the most common mode of injury (80%). Five (50%) of the patient had right side involvement and five (50%) left-sided. Four (40%) patients had excellent outcomes, four (40%) good, and two (20%) fair. Three patients had complications like superficial skin infection, broken k-wire, and persistent pain due to missed calcaneocuboid subluxation preoperatively.
Conclusion: All chronic neglected peritalar dislocations need open reduction and K-wire fixation. Preoperative computed tomography (CT) scan, proper operative planning, if needed use of distractor for reduction is useful in some cases. Meticulous soft tissue handling is key factor for better outcome. Long-term follow-up is needed to know about the talus osteonecrosis and post-traumatic arthritis.
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