PMC6387697_01
(a) Preoperative AP view of the left ankle: vertical shear fracture of medial distal tibia, horizontal lateral malleolus fracture, and talus fracture. (b) Preoperative lateral view of the left ankle: posterior dislocation of the distal fibula, talar neck fracture, and distal tibia fracture. The array shows the distal fibula dislocated posterior of the tibia and talus.
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Plain film radiographs showed a posterior dislocated distal fibula fracture, a comminuted vertical shear fracture of the medial distal tibia and a talus fracture (Figure 1).
Preoperative CT scan of the left ankle with (a) the sagittal view of the pilon fracture and the split fracture of the talus, (b) distal fibula pushing the talus fragment anterior, (c) frontal view of the pilon fracture and the talus split fracture, (d) axial view with the fibula in the incisura, (e) fibula splitting the tibial plafond, and reconstruction of the left foot in (f) frontal anterior, (g) frontal posterior, and (h) sagittal lateral views.
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In order to obtain a precise diagnosis and plan surgery, a computed tomography (CT) scan of the ankle was performed, showing a dislocated distal fibula in contact with the posterior medial part of the talus, a multifragmentary talus fracture with a sagittal split and a separation between the body and neck and an AO 43-B2 distal tibia fracture (Figure 2).
(a) AP and (b) lateral X-rays of the left ankle at 6 months, showing consolidated fractures and an anatomical reconstruction, with the absence of necrosis of the talus.
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The X-rays showed an anatomical reconstruction, with no sign of talar necrosis (Figure 3).
(a) AP and (b) lateral X-rays of the left ankle at 1 year, showing necrosis of the talus and pilon, with anteromedial articular conflict.
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