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J Foot Ankle Surg. 2015 Sep-Oct;54(5):962-6. doi: 10.1053/j.jfas.2014.04.009. Epub 2014 May 17.

Irreducible Fracture-Dislocation of the Ankle Associated With Interposition of the Tibialis Posterior Tendon in the Syndesmosis: A Case Report.

Author information

1
Orthopaedic Resident, Department of Orthopaedic Surgery, CHU de Québec-Hôpital Enfant-Jésus, Québec, Québec, Canada.
2
Orthopaedic Surgeon and Clinical Professor, Department of Orthopaedic Surgery, CHU de Québec-Centre Hospitalier de l'Université Laval (CHUL), Québec, Québec, Canada. Electronic address: melissa.laflamme.2@ulaval.ca.
3
Orthopaedic Surgeon, BC Foot and Ankle Clinic, St. Paul's Hospital; and Clinical Associate Professor, University of British Columbia, Vancouver, British Columbia, Canada.

Abstract

Although ankle fracture-dislocations are common orthopedic injuries, it is very uncommon for them to be irreducible, and such cases require special attention. We report the case of a closed fracture-dislocation of the ankle in a 17-year-old male that required 3 surgeries because of persistent anterior subluxation of the talus on the postoperative radiographs. After advanced radiologic investigations, tibialis posterior tendon interposition in the syndesmosis was identified as the cause of the subluxation. This is a very rare event, reported in only 5 patients in published studies. Once the diagnosis was identified by magnetic resonance imaging, the tendon was relocated to its anatomic position, and the tibiofibular and tibiotalar joints were reduced adequately. The patient was then able to regain a satisfactory level of function many months after the initial trauma.

KEYWORDS:

ankle fracture; fibula; irreducible dislocation; subluxation; tibia; trauma

PMID:
24846161
DOI:
10.1053/j.jfas.2014.04.009
[Indexed for MEDLINE]
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