Talar fracture associated with cuboid fracture in a 9-year-old boy: case report

Abstract

Introduction: The talus has a unique anatomy and plays a fundamental role in the function of theankle and foot. Talar fractures are considered an orthopedic emergency, especially displaced neckfractures, due to the high risk of avascular necrosis. However, these are rare in children with anestimated prevalence of 0.008% of all pediatric fractures. Talar neck fractures are associated witha high rate of complications, the most important of which include post-traumatic osteoarthritisand avascular necrosis. These are mainly related to the degree of initial displacement of the talarneck and the incidence can be 100%. Objectives: The objectives of this work are to demonstrate the evolution of a patient with a rarepathology, with an injury association not reported so far and to carry out a bibliographic review ofthe topic. Material and methods: A 9-year-old male patient with a talar neck fracture dislocation of the leftfoot associated with a cuboid fracture was retrospectively evaluated. Clinical, radiological and functional results were evaluated after 3 years of evolution. Results: In our case, open reduction and percutaneous fixation were performed. Excellent boneunion was achieved without complications and with good ankle functionality after 3 years of follow-up. The AOFAS scale was performed, obtaining a score of 93/100. It did not present limitations interms of pain, with a total of 40 points, it did not show limitations in terms of function, with a totalof 45 points. We observed a slight valgus dexation of the hindfoot, asymptomatic, with a total of 8points. Conclusions: Talar fractures are rare in the pediatric population but can cause seriouscomplications. In our case we observed a serious fracture, with an injury association not describeduntil now, which presented a very good evolution, with bone consolidation, without complicationsand with good functional result 3 years after surgery. As it is a very infrequent and rare pathology, the literature reviewed is generally of low scientificevidence and is based mostly on clinical case reports, except for a systematic review with a lownumber of patients.