Atypical lesional association (Talus Fracture + Pilon Fracture): A case report

Background: Talus fractures represent 3% to 6% of all foot and ankle fractures and are frequently associated with significant morbidity and poor outcomes. They typically result from high-energy trauma, such as motor vehicle accidents or falls from heights. The combination of talar body and tibial plafond fractures is particularly rare, with few cases reported in the literature. Case Report: We present the case of a 20-year-old female who sustained a closed injury to her right ankle after a 6-meter fall. Clinical examination revealed swelling, pain, and bruising without skin opening or neurovascular disturbances. Radiographs and a CT scan identified a non-displaced fracture of the tibial plafond, a medial malleolus fracture, and a posterior process talus fracture. The patient underwent closed reduction and internal fixation with percutaneous screws. At six months post-surgery, she exhibited a good functional outcome with minimal residual pain and slight limitations in ankle movement. Discussion: Talar body fractures commonly result from falls that exert axial compression or shearing forces. Severe cases involve comminution of the ankle and subtalar joints, often accompanied by malleoli fractures. The concomitant fracture of the tibial plafond and talus, as seen in this case, is rare. Managing such injuries is challenging due to high risks of avascular necrosis, subtalar arthritis, and restricted ankle motion. Thorough radiographic and clinical assessments are crucial for effective management, emphasizing the need for careful preoperative planning, precise anatomical reduction, and stable fixation. Conclusion: This rare case of combined talus body and tibial plafond fractures highlights the importance of comprehensive evaluation and appropriate management to minimize serious complications.