1: Foot Ankle  1992 Oct;13(8):473-7 

Open total dislocation of the talus with extrusion (missing talus): report of
two cases.

Hiraizumi Y, Hara T, Takahashi M, Mayehiyo S.

Department of Orthopaedic Surgery, Showa University, Tokyo, Japan.

Two different methods of treatment for open dislocation of the extruded talus
without soft tissue attachments (missing talus) were examined. In case 1, a
20-year-old man sustained an open total dislocation of the talus due to a
motorcycle accident. The missing talus was found within 3 hr and replaced after
thorough washing and debridement. Weightbearing was permitted at 20 weeks;
however, the density of the talar body increased in the x-ray and
nonweightbearing status was resumed. Reexamination at 2 1/2 years revealed that
there was joint space narrowing on the x-ray and decreased pain with ambulation;
the patient had returned to his job. In case 2, a 26-year-old man sustained an
open total dislocation of the talus with a severe crush wound and impaired
circulation to the foot. After thorough washing and debridement of the wound,
the calcaneus and distal end of the tibia were aligned. The missing talus was
found 3 days later, but not replaced. Weightbearing was allowed on the affected
foot at 2 months; however, the patient felt pain at the joint surfaces and
arthrodesis was consequently performed. At 2 1/2 years, the patient had a 4.0-cm
leg length discrepancy in the involved extremity, but felt no pain when walking.
Although reduction of the talus is ideal to preserve function and length of the
extremity, several complications can occur. A review of literature on open total
dislocation of the talus with extrusion was performed.

PMID: 1483609 [PubMed - indexed for MEDLINE]