Abstract
Fractures of the sustentaculum tali and body of the talus are rare high energy injuries. Thorough clinical examination as well as proper imaging studies are necessary in order not to miss this kind of fractures. Severity of the injury, amount of displacement, soft tissue compromise, accuracy of reduction as well as stability of fixation are the main factors affecting the outcome. This study presents a case of a 19-year-old patient, who sustained a sustentaculum tali fracture with a concomitant lateral talar body fracture after a motor vehicle accident. Open reduction and internal fixation were performed. Sustentaculum tali fracture was approached through a plan between the posterior tibialis and the flexor digitorum longus tendon. Fibular door osteotomy was required in order to approach and fix the lateral talar body fracture. The surgical technique is described in details. Postoperative protocol and six months post-surgery outcome are demonstrated as well.
Highlights
Sustentaculum tali and talar body fractures are rare injuries resulting from high energy trauma in young patients [1,2]
This study presents a case of a 19-year-old patient, who sustained a sustentaculum tali fracture with a concomitant lateral talar body fracture after a motor vehicle accident
Sustentaculum tali fracture was approached through a plan between the posterior tibialis and the flexor digitorum longus tendon
Summary
Sustentaculum tali and talar body fractures are rare injuries resulting from high energy trauma in young patients [1,2]. Concomitant fractures of these structures on the same foot are even rarer. An anterolateral ankle incision was performed starting approximately 4 cm above the level of the ankle joint extending distally, just proximally to the base of the 4th metatarsal As it was decided preoperatively, a distal fibular door osteotomy was performed in order to approach the fracture of the lateral talar body. A back slab of the ankle joint was applied and no weight bearing was instructed to the patient for 6 weeks. Patient has been informed though that, despite the good radiographic result, complications, such as chronic pain due to avascular necrosis or joint posttraumatic degenerative changes are likely to occur in the future
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