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Reconstruction of Chronic Subtalar Dislocation

INTRODUCTION: Subtalar dislocations are a rare injury, comprising 1–2% of all large joint dislocations and 15% of all peri-talar injuries. Most subtalar dislocations are managed acutely, with the documented reconstruction of chronic dislocations rare. This case report aims to present our experience...

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Autores principales: Chan, MC, Khan, Suheal A, Tan, Jeffrey GM
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Jaypee Brothers Medical Publishers 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7001597/
https://www.ncbi.nlm.nih.gov/pubmed/32559268
http://dx.doi.org/10.5005/jp-journals-10080-1412
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author Chan, MC
Khan, Suheal A
Tan, Jeffrey GM
author_facet Chan, MC
Khan, Suheal A
Tan, Jeffrey GM
author_sort Chan, MC
collection PubMed
description INTRODUCTION: Subtalar dislocations are a rare injury, comprising 1–2% of all large joint dislocations and 15% of all peri-talar injuries. Most subtalar dislocations are managed acutely, with the documented reconstruction of chronic dislocations rare. This case report aims to present our experience with the first documented use of an Ilizarov frame for bony and soft tissue reconstruction in a case of chronic subtalar dislocation. MATERIALS AND METHODS: A single patient surgically treated for chronic subtalar dislocation was followed over a 2-year period, and retrospectively reviewed. RESULTS: A 67-year-old lady presented with an over 10-year history of worsening ankle pain and significant varus deformity with skin contractures, limiting ambulation over the past 6 months. Computed tomography confirmed medial dislocations of the subtalar and talonavicular joints with head and neck fractures of the talus and generalized osteoarthritis. A two-stage reconstruction involving an Ilizarov frame and subsequent arthrodesis allowed for correction of soft tissue and bone with the return of independent ambulation. CONCLUSION: Although the correction of bony deformities is important in reconstruction, soft tissue management is crucial and must not be overlooked. An Ilizarov frame is ideal for correction of both the bony deformity and soft tissue contractures. Arthrodesis can be performed when the overlying soft tissue is able to accommodate correction of the varus deformity and reduction of the dislocations. While an Ilizarov frame requires both an experienced surgeon and a motivated patient, in the right hands, good functional recovery can be returned. HOW TO CITE THIS ARTICLE: Chan MC, Khan SA, Tan JGM. Reconstruction of Chronic Subtalar Dislocation. Strategies Trauma Limb Reconstr 2019;14(1):53–56.
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spelling pubmed-70015972020-02-11 Reconstruction of Chronic Subtalar Dislocation Chan, MC Khan, Suheal A Tan, Jeffrey GM Strategies Trauma Limb Reconstr Case Report INTRODUCTION: Subtalar dislocations are a rare injury, comprising 1–2% of all large joint dislocations and 15% of all peri-talar injuries. Most subtalar dislocations are managed acutely, with the documented reconstruction of chronic dislocations rare. This case report aims to present our experience with the first documented use of an Ilizarov frame for bony and soft tissue reconstruction in a case of chronic subtalar dislocation. MATERIALS AND METHODS: A single patient surgically treated for chronic subtalar dislocation was followed over a 2-year period, and retrospectively reviewed. RESULTS: A 67-year-old lady presented with an over 10-year history of worsening ankle pain and significant varus deformity with skin contractures, limiting ambulation over the past 6 months. Computed tomography confirmed medial dislocations of the subtalar and talonavicular joints with head and neck fractures of the talus and generalized osteoarthritis. A two-stage reconstruction involving an Ilizarov frame and subsequent arthrodesis allowed for correction of soft tissue and bone with the return of independent ambulation. CONCLUSION: Although the correction of bony deformities is important in reconstruction, soft tissue management is crucial and must not be overlooked. An Ilizarov frame is ideal for correction of both the bony deformity and soft tissue contractures. Arthrodesis can be performed when the overlying soft tissue is able to accommodate correction of the varus deformity and reduction of the dislocations. While an Ilizarov frame requires both an experienced surgeon and a motivated patient, in the right hands, good functional recovery can be returned. HOW TO CITE THIS ARTICLE: Chan MC, Khan SA, Tan JGM. Reconstruction of Chronic Subtalar Dislocation. Strategies Trauma Limb Reconstr 2019;14(1):53–56. Jaypee Brothers Medical Publishers 2019 /pmc/articles/PMC7001597/ /pubmed/32559268 http://dx.doi.org/10.5005/jp-journals-10080-1412 Text en Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd. © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Chan, MC
Khan, Suheal A
Tan, Jeffrey GM
Reconstruction of Chronic Subtalar Dislocation
title Reconstruction of Chronic Subtalar Dislocation
title_full Reconstruction of Chronic Subtalar Dislocation
title_fullStr Reconstruction of Chronic Subtalar Dislocation
title_full_unstemmed Reconstruction of Chronic Subtalar Dislocation
title_short Reconstruction of Chronic Subtalar Dislocation
title_sort reconstruction of chronic subtalar dislocation
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7001597/
https://www.ncbi.nlm.nih.gov/pubmed/32559268
http://dx.doi.org/10.5005/jp-journals-10080-1412
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