Complete posterior dislocation of the talus. Case report and discussion.

Complete dislocation of the talus is an injury that is produced by a great magnitude of force, producing severe soft tissue injury, frequently vascular compromise, often with subsequent avascular necrosis. Complete posterior dislocation of the talus seems not to have been reported previously. The treatment in a 39-year-old man was designed on the basis of experience with antero-medial dislocation. Treatment ranges from attempted anatomical reduction to early arthrodesis of one or all of the articulations of the talus, with and without talectomy. No one method has shown to be superior to the others. Oen reduction is often unsuccessful, probably because of ankle malalignment. Avascular necrosis of the talus without collapse is not necessarily painful. In the present case talectomy and tibio-calcaneal fusion was performed one year after injury. The symptomatic results were good. Accurate anatomical reduction should be the aim of initial therapy. Definitive therapy can be designed to fit the requirements of the individual case.