Pantalar Intact Dislocation: A Systematic Review.

Abstract

Background: This scoping review analyzes the available literature on pure total talar dislocation, focusing on its epidemiology, clinical presentation, imaging techniques, surgical options, rehabilitation protocols, and complications.

Methods: Following the PRISMA-ScR guidelines, a comprehensive search was conducted across the PubMed, Web of Science, and Scopus databases. The search yielded 185 articles, of which 30 satisfied the inclusion criteria and focused on pure total talar dislocation without fractures. Data from each study were extracted, including patient demographics, injury characteristics, treatment methods, and outcomes.

Results: The studies included case reports, case series, and reviews. Despite the heterogeneity of the studies, the key findings suggest that early reduction, careful wound management, and soft tissue preservation are crucial in minimizing complications such as avascular necrosis (AVN), post-traumatic arthritis, and infection. The long-term outcomes varied, and the risk of AVN remained high, particularly in cases with compromised blood supply to the talus.

Conclusions: Pure total talar dislocation is a rare and challenging condition with no established management protocol. While talar reimplantation and joint fixation offer promising outcomes in preserving function, the risk of complications, particularly AVN, remains significant. Additional research is necessary to standardize treatment protocols and improve clinical outcomes for this rare but severe injury.