Medial swivel dislocation, a variant of subtalar dislocation is uncommon. A 35 years old male presented after 6 weeks old injury to left ankle following motor cycle accident. He had pain, swelling around ankle and was unable to bear weight on left foot. Clinical examination revealed diffuse swelling and tenderness in mid foot region, His plain X rays and CT scan showed talonavicular dislocation with compression defect of the head of the talus. He was treated by open reduction and K-wire fixation. At 32 months follow up foot was painless, stable with normal range of ankle and subtalar motion.

Medial swivel dislocation of the talonavicular joint.

Injuries involving the midtarsal joint, which are frequently misdiagnosed, have been studied to clarify the mechanism, classification and treatment. The necessity for routine antero-posterior, lateral and oblique radiographs is emphasised. Seventy-one injuries have been classified according to the direction of the deforming force:medial, longitudinal compression, lateral, plantar and crush types are described. Included in the medial and lateral types is a hitherto undescribed tarsal rotation or "swivel" injury. The mechanism whereby longitudinal compression causes fractures of the body of the navicular is described, and two varieties having different prognoses are defined: one due to purely longitudinal compression and the other due to longitudinal compression with a medial component. The results of treatment have been assessed clinically and radiologically. Reduction, open if necessary, with internal fixation, is recommended for displace fractures: primary arthrodesis is not indicated. For severe persistent symptoms from medial and longitudinal force injuries triple arthrodesis is recommended, and from lateral force injuries, calcaneo-cuboid arthrodesis.

Injuries of the midtarsal joint

Isolated talonavicular dislocation is rare because of the strong plantar ligamentous structures that support the joint. It appears that plantarflexion and inversion of the foot is the mechanism of injury. Very often, the strong spring ligament or plantar calcaneonavicular ligament is injured. Surgical repair is often the desired treatment in case of ligamentous injury. In this case, closed reduction with percutaneous pinning is presented as an alternative to open surgery. Early anatomical reduction is the key to preventing long term complications such as midtarsal joint arthritis and faulty foot mechanics.

/pdf/complex-talonavicular-fracture-dislocation-a-case-report-3kwutjl74w.pdf

Complex Talonavicular Fracture Dislocation: A case report

Lateral swivel dislocation, a subtype pattern of dislocations occurring at mid tarsal joint is a rare type of injury. A medially or laterally directed force applied to the forefoot causes dislocation of the talonavicular joint but not subtalar joint. The calcaneum alongwith the remaining foot swivels on the intact inteross eous talocalcaneal ligament. The present case report is a more rare lateral swivel type of dislocation of talonavicular joint in a 25-year-old male. The article also presents a comprehensive review of literature and management of such type of injuries of the hindfoot .

/pdf/lateral-swivel-dislocation-of-the-hindfoot-a-case-report-and-5608zqmftf.pdf

Lateral Swivel Dislocation of the Hindfoot : A Case Report and Literature Review

Medial talonavicular dislocation associated with cuboid fracture is rare. We report an 18-year-old man with this injury who exhibited excellent results after open reduction and stabilization of the...

Medial Swivel Dislocation of the Talonavicular Joint with Associated Cuboid Fracture.

Lateral swivel dislocation of the talo-navicular joint

A swivel dislocation is an uncommon variant of a sub-talar dislocation, where a medially or laterally directed force dislocates the talonavicular joint, and subluxates but does not dislocate the subtalar joint. The calcanuem rotates or swivels on an intact interosseous talocalcaneal ligament without tearing it. It is important to recognise this injury as its treatment and prognosis differs form a subtalar dislocation. A case of lateral swivel dislocation of the talo-navicular joint treated by closed reduction and percutaneous wire fixation is reported. Excellent clinical and functional outcome were achieved. q 2005 European Foot and Ankle Society. Published by Elsevier Ireland Ltd. All rights reserved.

M. Hadidi

Papers

Lateral swivel dislocation of the talo-navicular joint

Case Report Lateral swivel dislocation of the talo-navicular joint