Medial talonavicular dislocation with nondisplaced navicular fracture: A case report.

Abstract

IntroductionTalonavicular dislocation is a rare injury that usually occurs following high-energy trauma. The mechanism of injury is a force of abduction or adduction applied to the forefoot. In this article, we present a rare case of medial talonavicular dislocation with a fracture of the navicular following low-energy trauma.Presentation of caseWe report a case of talonavicular dislocation with a navicular fracture in a 25-year-old male. He presented at the emergency department with a history of twisting injury to his left foot. Physical examination revealed an obvious deformity of his foot associated with tenderness. No neurological deficit was present. Radiograph and CT scan showed medial talonavicular dislocation and postero-lateral navicular fracture. Closed reduction was done followed by six weeks in a cast. The patient was followed up for six months and no complications were reported.DiscussionTalonavicular dislocation is commonly associated with ligamentous disruption and midfoot fractures. Most studies reported this type of dislocation in association with a fracture of the navicular, cuboid, talus, calcaneus or metatarsal bones as a result of high-energy trauma. However, in our case, the dislocation resulted from low-energy trauma and was associated with a nondisplaced fracture of the navicular and a minimally impacted fracture of the talus that was treated conservatively.ConclusionSince this type of dislocation is rare, it is important to recognize it early to avoid complications such as painful equinovarus deformity. Early reduction and immobilization is the ideal treatment for this injury.