Unusual presentation of a peritalar fracture dislocation

Abstract

A peritalar dislocation involves simultaneous disruption of the talocalcaneal and talonavicular joints. It is relatively uncommon and account for approximately 1% to 1.5% of all traumatic foot injuries. Medial dislocation is the most frequent accounting for approximately 80% of reported cases. Lateral peritalar dislocations are less common (17%), and posterior (2.5%) and anterior dislocations are rare (1%). Approximately 55% of medial and 72% of lateral subtypes are associated with fractures. A thirty-six-year-old woman had suffered an indirect traumatism during kite-surf practice and after falling from the kite-board near the beach trying to avoid an accident because of intense wind. She presented a lateral peritalar dislocation with navicular, calcaneal and fibular fractures associated. After the primary evaluation, a closed reduction was attempted three days from trauma. After six days of the lesion the surgery was perform. The fractures were treated with minimally invasive osteosynthesis and in the postoperative the patient developed a complex regional pain syndrome. We recomend an early diagnosis of peritalar dislocations and a correct recognition of infrequent fractures to avoid usual complications.