Isolated Talonavicular joint dislocation: A rare form of mid tarsal dislocation- Case report

Abstract

Aim: To report a case of, 2 months old, Isolated medial talonavicular dislocation.

Background: Isolated medial talonavicular dislocation is an uncommon injury occurring due to a medially directed force to the forefoot. The injury is usually associated with subtalar or calcaneo-cuboid dislocations and calcaneal or tarsal fractures. A swivel type mechanism is described for medial and lateral talonavicular dislocations. The treatment is largely case specific and there is no standard regimen described for the treatment of this injury.

Case description: We had a 21 years old female patient with a 2 months old injury to the right ankle following a road traffic accident. The patient complained of swelling over the right ankle associated with inability to bear weight over the right foot. On examination the patient had diffuse swelling and tenderness over the midfoot region. X rays and CT scans of the affected foot showed an isolated medial talonavicular dislocation with an intact subtalar and calcaneocuboid joint. The patient underwent open reduction internal fixation with 2 K wires. At 3 months follow up, post k wire removal, the right ankle was painless and reduction of talonavicular joint was stable with no signs of complications.

Conclusion: We conclude that if done meticulously open reduction and internal fixation of isolated talonavicular joint dislocation can have excellent outcomes with no post operative avascular necrosis or secondary osteoarthritis, even in old cases.

Clinical significance: There are a small number of reported cases of isolated talonavicular dislocation. This case report will help in adding to the knowledge on appropriate management of such cases using open reduction and internal fixation.