Management of Neglected Medial Peritalar Dislocations: A Preliminary Report with Clinical and Radiological Analysis of 10 Cases

Aim and objective: To study the functional outcome of neglected medial peritalar dislocations treated with open reduction and k-wire fixation and assess the clinical and radiological outcome of these neglected cases. Materials and methods:A prospective study was performed on 10 patients between June 2016 and July 2020.All the cases were treated with open reduction and internal fixation with k-wire fixation in the Department of Orthopaedics and private setup.We graded these injuries according to the AOFAS ankle hindfoot scale.Results: In our study, all the patients had closed injury and presented to us between 4 weeks to 8 weeks after injury without taking any primary treatment.The mean age group was 21-58 years of age with male predominance (60%).Road traffic accident (RTA) is the most common mode of injury (80%).Five (50%) of the patient had right side involvement and five (50%) left-sided.Four (40%) patients had excellent outcomes, four (40%) good, and two (20%) fair.Three patients had complications like superficial skin infection, broken k-wire, and persistent pain due to missed calcaneocuboid subluxation preoperatively.Conclusion: All chronic neglected peritalar dislocations need open reduction and K-wire fixation.Preoperative computed tomography (CT) scan, proper operative planning, if needed use of distractor for reduction is useful in some cases.Meticulous soft tissue handling is key factor for better outcome.Long-term follow-up is needed to know about the talus osteonecrosis and post-traumatic arthritis.