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Delayed Treatment of a Medial Swivel Talonavicular Dislocation

Kyle E. WamelinkDepartment of Foot and Ankle Orthopedics, Novant Health, Winston-Salem, NC.

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Robb MothershedDepartment of Foot and Ankle Orthopedics, Novant Health, Winston-Salem, NC.

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This case describes delayed treatment of a medial talonavicular dislocation with a shear fracture of the talar head, a comminuted posterior talar process fracture, and an intra-articular cuboid fracture with subtle medial displacement of the calcaneocuboid joint and the associated treatment. The injury was sustained in a 35-year-old man following a high-energy motor vehicle accident. Three weeks following the injury, delayed treatment was achieved following an attempted closed reduction under general anesthesia followed by open reduction and percutaneous Kirschner wire fixation. After a 12-month follow-up, the patient was able to return to work and regular activities pain-free without complications. Several associated injuries have been described with isolated talonavicular dislocations. This case reviews the technique and care surrounding this injury pattern and its delayed treatment.

Corresponding author: Kyle E. Wamelink, DPM, Novant Health, 3057 Trenwest Dr, Winston-Salem, NC 27103. (E-mail: kyle.wamelink@gmail.com; RMothershed@triad.rr.com)