Five patients with the very rare injury of a total dislocation of the talus were retrospectively studied. Rapid open reduction had successfully been performed in all patients. The mean followup was 4.5 years. Two cases developed an avascular necrosis of the talus. No talectomy was performed. The clinical results were good in three and fair in two patients. It is concluded that the choice of treatment is a rapid open reduction. In case of an avascular necrosis of the talus, weight bearing must be postponed. A talectomy must be avoided.