Peritalar dislocation: three case reports and literature review

Peritalar dislocation is an uncommon lesion, although its incidence has increased on account of the rise in motor vehicle accidents and improved radiological diagnostic techniques. In our review of the literature, we counted 312 cases described over the past 50 years. Medial dislocation represented the majority of cases (79%), lateral dislocation accounted for 22%, while poster and anterior dislocations seemed to occur rarely. We report the results of the treatment of 3 patients, one with an irreducible lateral dislocation, one with a irreducible medial dislocation, and one with a reducible medial dislocation. The obstruction to closed reduction for lateral dislocation was the interposed posterior tibial tendon. The obstruction to closed reduction for medial dislocation was an osteochondral impact-fracture of the upper medial part of the head of the talus spiking to the lateral corner of the navicular. Management consisted of immediate reduction and application of a short leg cast for 4 weeks. At long-term follow-up, all 3 patients had no complications and had returned to their pre-injury activities.