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Introduction: Extrusion of the talus with fracture dislocation is a very rare and devastating ankle injury usually caused by high-energy impact. There is no common consensus on the management for this type of injury. We intend to report on our experiences with its management and outcomes. Case Report: We received a total of five cases of extruded fracture dislocation of the talus between March 2016 and April 2020. All fracture talus was Hawkins Type IV fracture. All five patients were male with an age range between 18 and 54 years and have sustained an injury in road traffic accidents. They were managed with wound debridement, talar preservation open reduction, and internal fixation with an application of an external fixator for wound care. All were followed up for 2 years. Conclusion: Extruded fracture dislocation of the talus is a rare and devastating ankle injury. Its management is time-dependent and involves meticulous planning for a favorable outcome.
RESUMEN
Introduction Greenstick and angulated forearm bone fractures are the most common fractures in children and invariably require closed reduction under anesthesia. However, pediatric anesthesia is somewhat risky and not always available in developing countries like India. Therefore, this study aimed to evaluate the standard (quality) of closed reduction without anesthesia in children and to determine satisfaction among parents. Materials and methods The present study included 163 children with closed angulated fractures of the distal radius and fracture shafts of both forearm bones, who were treated by closed reduction. One hundred and thirteen were treated without any anesthesia (study group) on an outpatient department (OPD) basis, whereas 50 children of similar age and fracture type underwent reduction with anesthesia (control group). After reduction by both methods check X-ray was done to evaluate the quality of the reduction. Results The average age of the 113 children in the present study was 9.5 years (range: 3.5-16.2 years), of which 82 children had radius or ulna fractures, and 31 had isolated distal radius fractures. In 96.8% of children, ≤10° of residual angulation was achieved. Furthermore, 11 children (12.4%) used paracetamol or ibuprofen for pain control in the study group. Moreover, 97.3% of parents stated that they would like their children to be treated without anesthesia if any fracture occurred again. Conclusions Closed reduction of greenstick angulated forearm and distal-end radius fracture in children in the OPD without anesthesia achieved satisfactory reduction and high parent satisfaction while reducing the risks of pediatric anesthesia and its associated complications.