PURE DISLOCATION OF THE TIBIO-TALAR JOINT - REPORT OF 9 CASES

Purpose of the study The authors relate nine cases of pure traumatic d islocation of the tibio talar joint and propose to evaluate the clinic al and radiological results at a long term follow-up (mean 12 years). Material and methods The serie included 9 patients (7 men and 2 women) the average age was 33,2 years. The injury was a road trafic accident in 5 cases. Pure dislocation variety of the ankle joint was medial an d posteromedial in 6 cases. Open skin injury was found in 7 cases. The mean follow-up was 12 years (5-19 years). 6 patients were reviewed by the same surgeon, 6 patients were examined clinically and with ankle Xrays. All patients except one were treated by reduction, immobilizati on with a plaster cast for 6 to 8 weeks. The joint was examined radiog raphically to detect the presence of tibio talar diastasis and degener ative arthritis. Results At terme we had two very good results and 3 g ood results (no pain or pain occasionnaly). We have found in 5 cases a degenative arthritis to the ankle joint (joint narrowing < 50 per cen t in 3 cases, > to 50 per cent in 2 cases). No joint instability was n oted at revision. Discussion Pure traumatic dislocation of the tibio t alar joint is a rare injury. Medial and posteromedial variety are not frequent. Immediate gravity is dominated by vascular and septic compli cations and long term result by degenerative arthritis. Conclusion The authors think that closed dislocations need orthopedic treatment (clo sed reduction and immobilization with a plaster cast for 6 weeks), on the other hand, open dislocation need surgical treatment (reduction, l igamentous reconstruction and immobilization in a plaster cast for 6 w eeks).