Clinical Case Report of Long-Term Follow-Up in a Rare Neck Talus Fracture and Talonavicular Dislocation

Introduction: Talus fracture is one type of fracture that is quite rare with a prevalence of about 0.008% in children and 0.3% in adults. It was known that avascular necrosis, malunion, and osteoarthritis are the most prevalent complications in talus fracture. However, these complications may not occur in short period. Objective: We want to present a case of a 24 years old man with neck talus fracture accompanied by talonavicular dislocation that we have been followed for a year. Case Presentation: A 24 years old man complained pain in his right leg since 7 days ago after falling into a 1-meter-deep sewer with his feet on the ground. These complaints made the patient unable to work because of difficulty walking and had to use a cane as a tool. Right ankle examination showed edema, tenderness, crepitus, warm sensation, and limited range of movement (ROM). Radiographic imaging showed ruptured synovium right ankle. He was diagnosed with talus fracture (Hawkins II) and planned to undergo open reduction internal fixation with K-wire joystick incised from lateral approach. After a year follow up, radiographic examination did not show any decreased joint space, juxta-articular osteophytes, subchondral sclerosis and/or subchondral cysts, and osteonecrosis. Conclusion: It is recommended that patient with talus fracture must be followed until a year post-surgery since complications may happen in long term period. Besides, serial functional assessments, serial radiographic also need to be assessed to eliminate avascular necrosis. Keywords: talus fracture, avascular necrosis, Hawkin sign, long term follow up