A Fixed, Unreducible, Unstable Medial Swivel Dislocation of the Talonavicular Joint with Associated Navicular Fracture

A 32-year-old white male was on a second-story balcony when he fell off and landed on the cement below. With initial X-rays being read as negative on the radiology report due to the subtle nature of the injury, the patient was promptly diagnosed with a medial swivel dislocation by the orthopaedic te...

Full description

Saved in:
Bibliographic Details
Main Authors: James T. Layson, Alan Afsari, Todd Peterson, David Knesek, Benjamin Best
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Orthopedics
Online Access:http://dx.doi.org/10.1155/2021/9959830
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849308328817065984
author James T. Layson
Alan Afsari
Todd Peterson
David Knesek
Benjamin Best
author_facet James T. Layson
Alan Afsari
Todd Peterson
David Knesek
Benjamin Best
author_sort James T. Layson
collection DOAJ
description A 32-year-old white male was on a second-story balcony when he fell off and landed on the cement below. With initial X-rays being read as negative on the radiology report due to the subtle nature of the injury, the patient was promptly diagnosed with a medial swivel dislocation by the orthopaedic team, which ended up being fixed, unstable, and irreducible. The patient also had acute skin compromise and needed to be taken to the operating room prior to progression of skin breakdown. This dislocation pattern is a rare variant, especially when paired with the fixed nature of the dislocation and the soft tissue compromise. In the end, open treatment was necessary in order to reduce the talonavicular joint. Because of early recognition and prompt treatment, skin breakdown was avoided. Internal screw fixation of the fractured navicular bone was needed along with K-wire insertion to hold the normal anatomy of the talonavicular joint reduced. All hardware was ultimately removed after healing, and anatomy was restored with excellent patient function. This case report highlights the orthopaedic knowledge needed to not only recognize this rare fracture-dislocation pattern but to also treat it promptly when encountered.
format Article
id doaj-art-0e0f6fd2ef41401bb51e86f132acaee9
institution Kabale University
issn 2090-6749
2090-6757
language English
publishDate 2021-01-01
publisher Wiley
record_format Article
series Case Reports in Orthopedics
spelling doaj-art-0e0f6fd2ef41401bb51e86f132acaee92025-08-20T03:54:28ZengWileyCase Reports in Orthopedics2090-67492090-67572021-01-01202110.1155/2021/99598309959830A Fixed, Unreducible, Unstable Medial Swivel Dislocation of the Talonavicular Joint with Associated Navicular FractureJames T. Layson0Alan Afsari1Todd Peterson2David Knesek3Benjamin Best4Ascension Macomb-Oakland, 11800 Twelve Mile Rd, Warren, MI 48093, USAAscension St. John Hospital, 22101 Moross Road, Suite #214 Detroit, MI 48236, USACapital Orthopaedics and Sports Medicine, 12499 University Ave., Suite #210 Clive, IA 50325, USAMotor City Orthopedics and Ascension Providence Hospital, 26850 Providence Parkway, #260 Novi, MI 48374, USAAscension Macomb-Oakland and Ascension St. John Hospital, 22101 Moross Road, Suite #214 Detroit, MI 48236, USAA 32-year-old white male was on a second-story balcony when he fell off and landed on the cement below. With initial X-rays being read as negative on the radiology report due to the subtle nature of the injury, the patient was promptly diagnosed with a medial swivel dislocation by the orthopaedic team, which ended up being fixed, unstable, and irreducible. The patient also had acute skin compromise and needed to be taken to the operating room prior to progression of skin breakdown. This dislocation pattern is a rare variant, especially when paired with the fixed nature of the dislocation and the soft tissue compromise. In the end, open treatment was necessary in order to reduce the talonavicular joint. Because of early recognition and prompt treatment, skin breakdown was avoided. Internal screw fixation of the fractured navicular bone was needed along with K-wire insertion to hold the normal anatomy of the talonavicular joint reduced. All hardware was ultimately removed after healing, and anatomy was restored with excellent patient function. This case report highlights the orthopaedic knowledge needed to not only recognize this rare fracture-dislocation pattern but to also treat it promptly when encountered.http://dx.doi.org/10.1155/2021/9959830
spellingShingle James T. Layson
Alan Afsari
Todd Peterson
David Knesek
Benjamin Best
A Fixed, Unreducible, Unstable Medial Swivel Dislocation of the Talonavicular Joint with Associated Navicular Fracture
Case Reports in Orthopedics
title A Fixed, Unreducible, Unstable Medial Swivel Dislocation of the Talonavicular Joint with Associated Navicular Fracture
title_full A Fixed, Unreducible, Unstable Medial Swivel Dislocation of the Talonavicular Joint with Associated Navicular Fracture
title_fullStr A Fixed, Unreducible, Unstable Medial Swivel Dislocation of the Talonavicular Joint with Associated Navicular Fracture
title_full_unstemmed A Fixed, Unreducible, Unstable Medial Swivel Dislocation of the Talonavicular Joint with Associated Navicular Fracture
title_short A Fixed, Unreducible, Unstable Medial Swivel Dislocation of the Talonavicular Joint with Associated Navicular Fracture
title_sort fixed unreducible unstable medial swivel dislocation of the talonavicular joint with associated navicular fracture
url http://dx.doi.org/10.1155/2021/9959830
work_keys_str_mv AT jamestlayson afixedunreducibleunstablemedialswiveldislocationofthetalonavicularjointwithassociatednavicularfracture
AT alanafsari afixedunreducibleunstablemedialswiveldislocationofthetalonavicularjointwithassociatednavicularfracture
AT toddpeterson afixedunreducibleunstablemedialswiveldislocationofthetalonavicularjointwithassociatednavicularfracture
AT davidknesek afixedunreducibleunstablemedialswiveldislocationofthetalonavicularjointwithassociatednavicularfracture
AT benjaminbest afixedunreducibleunstablemedialswiveldislocationofthetalonavicularjointwithassociatednavicularfracture
AT jamestlayson fixedunreducibleunstablemedialswiveldislocationofthetalonavicularjointwithassociatednavicularfracture
AT alanafsari fixedunreducibleunstablemedialswiveldislocationofthetalonavicularjointwithassociatednavicularfracture
AT toddpeterson fixedunreducibleunstablemedialswiveldislocationofthetalonavicularjointwithassociatednavicularfracture
AT davidknesek fixedunreducibleunstablemedialswiveldislocationofthetalonavicularjointwithassociatednavicularfracture
AT benjaminbest fixedunreducibleunstablemedialswiveldislocationofthetalonavicularjointwithassociatednavicularfracture