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            [0] => Tibiotalar and subtalar dislocation:  case report
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            [0] => CHU taher sfar mahdia
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    [nom] => Array
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            [0] => dhief
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    [prenom] => Array
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            [0] => jawhar
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Nom prénom / Name Surname: trabelsi ahmed
Email: drtrabelsiahmed@gmail.com
Hôpital / Hospital: CHU taher sfar mahdia

 
Nom prénom / Name Surname: khalifa issam
Email: issamkhalifa.ortho@gmail.com
Hôpital / Hospital: CHU taher sfar mahdia

 
Nom prénom / Name Surname: Cheikhrouhou hassen
Email: hassen_ch_ro@yahoo.fr
Hôpital / Hospital: CHU taher sfar mahdia

 
Nom prénom / Name Surname: ben ghozlen hazem
Email: hazem_ben_ghozlen@yahoo.fr
Hôpital / Hospital: CHU taher sfar mahdia

 
Nom prénom / Name Surname: abid faouzi
Email: abidfawzi@yahoo.fr
Hôpital / Hospital: CHU taher sfar mahdia

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    [mots_cles] => Array
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            [0] => tibiotalar , subtalar , dislocation , open reduction;

        )

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            [0] => 3663
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    [specialite] => Array
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            [0] => Chirurgie orthopédique et traumatologique
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            [0] => Tunisie
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            [0] => Poster.
-Introduction:
Complete tibiotalar and subtalar dislocation is a rare injury, it represents only 1% of all dislocations observed in traumatology. always caused by violent trauma and high velocity
-Observation:	
The authors report the case of a 71-year-old male patient with no previous pathological history, suffered a high-speed motor vehicle collision resulting an open trauma to the left ankle.
X-rays and CT scan showed a subtotal tibiotalar dislocation ,total subtalar medial dislocation , associated to navicular and talar posterior process fracture of the left ankle.
The treatment was an open reduction and articular fragment resection, using two appraoces.
Talo-navicular pinning ligament suture as been performed followed by plaster cast immobilisation.
The follow-up at six months post-operative was satisfying in terms of mobility and indolence.
-Discussion and conclusion:
The enucleation fracture of the talus is a rare entity, associated with osteoligamentous lesions, which makes reduction difficult and necessitates open repair, even using a double anteromedial and anterolateral approach allowing reduction, resection of intra-articular fragments and ligament repair.	
The risk of talar necrosis is highly probable but the persistence of some tibio talar ligament attachment may reduce this risk. Long-term follow-up is necessary to detect signs of necrosis.
Long-term prognosis is good except in cases of skin opening or associated fracture, which may lead to osteoarthritis. Association with cartilage lesions is frequent and found in 67% of cases.
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