Abstract
Aim: Fractures of talar body are high energy injuries with controversial definition, classification and outcomes. Our purpose is to present combination of fractures of talar body and pantalar extension/subluxation/dislocation, clinical pathodynamics and modification of Muller AO/OTA Classification. Material & Methods: A 63-year old man was admitted with comminuted coronal shear fracture of talar body with subluxation of ankle, subtalar and talonavicular joints. Closed anatomical reduction and stable osteosynthesis was accomplished with two percutaneous cannulated screws from posteromedial and anterolateal approaches. Talonavicular joint was stable. A 43-year old man was admitted with polytrauma including head and facial injuries, comminuted fracture of posterior part of right talar body with pantalar dislocation and fractures of left radius and navicular. Open reduction of pantalar dislocation and K-wire stabilisation was performed. A 77-year old diabetic lady with CT evidence of comminuted fracture of talar body with pantalar extension and fracture of navicular and chronic circulatory insufficiency on delayed presentation one month after injury was treated conservatively. Results: Two cases of talar body fractures with pantalar dislocation, treated by open reduction, were previously reported. Muller AO/OTA Classification comprises CI – Ankle joint involvement, C2 – Subtalar joint involvement, C3 – Ankle and subtalar joint involvement. We extend the classification to include C4 – Ankle, subtalar and talonavicular joint involvement. Conclusions: Our patients have association of fracture of talar body with pantalar extension/subluxation/dislocation. Our modification fills the void in Muller AO/OTA Classification by inclusion of C4.
Published Version
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