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Case Presentation Total Talar Dislocation TTD. BASSAM ALAHMADI Orthopedic Resident R5 King Fahad Hospital Madina KSA. TTD. History: 30 yrs old, otherwise healthy man. Presented with hx of FD 3-meters height in a construction hole. Axial load to the Rt ankle
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Case PresentationTotal Talar DislocationTTD BASSAM ALAHMADI Orthopedic Resident R5 King Fahad Hospital Madina KSA
TTD History: • 30 yrs old, otherwise healthy man. • Presented with hx of FD 3-meters height in a construction hole. • Axial load to the Rt ankle • Twisting inj. to the Lt ankle
TTD P/E: ATLS protocol Lt foot> • Deformity with marked prominence anterior the left malleolus. • No open wounds. • Signs of skin compromise. • Delayed capillary refill. • Neurologically is intact. Rt foot> Tenderness and swelling around the heel.
TTD Treatment Closed reduction under anaesthesia with aid of calcaneal traction.
TTD Following closed reduction , how can we test for stability? Should we transfix the talus in a stable one? After how long an AVN can be developed?