An Incidental Finding of a Talonavicular and Talocalcaneal Joint Coalition After a Tibial Pilon Fracture: A Case Report

J Foot Ankle Surg. 2017 Nov-Dec;56(6):1332-1334. doi: 10.1053/j.jfas.2017.06.005. Epub 2017 Aug 18.

Abstract

It has been proposed that patients with talocalcaneal and talonavicular coalitions have decreased ankle joint range of motion. It has also been reported that rotational forces regularly absorbed by the talocalcaneal joint are transferred to the ankle joint in patients with coalitions, increasing the stress on the ankle joint after trauma. To the best of our knowledge, only 1 reported study has detailed the increased stress placed on the ankle joint secondary to a coalition. We present a case study of a 53-year-old female who experienced a traumatic fall and subsequent right ankle fracture. Advanced imaging studies revealed a comminuted tibial pilon fracture and talocalcaneal and talonavicular joint coalitions. She underwent open reduction and internal fixation for treatment of the fracture, and the coalitions were not treated because they were asymptomatic. She was kept non-weightbearing for 6 weeks postoperatively and was returned to a regular sneaker at 10 weeks postoperatively. The postoperative films revealed stable intact fixation and pain-free gait with no increased restriction in her ankle joint range of motion. The hardware was removed at 13 months postoperatively. She had not experienced increased pain or arthritic changes at 15 months postoperatively.

Keywords: pilon; subtalar joint; talocalcaneal; talocrural; talonavicular; tarsal coalition.

Publication types

  • Case Reports

MeSH terms

  • Accidental Falls
  • Ankle Fractures / diagnostic imaging
  • Ankle Fractures / surgery
  • Asymptomatic Diseases
  • Bone Wires
  • Female
  • Foot Deformities, Congenital / diagnosis*
  • Fracture Fixation, Internal / methods*
  • Fractures, Comminuted / diagnostic imaging
  • Fractures, Comminuted / surgery*
  • Humans
  • Incidental Findings
  • Middle Aged
  • Monitoring, Intraoperative / methods
  • Monitoring, Physiologic / methods
  • Prognosis
  • Risk Assessment
  • Subtalar Joint / physiopathology*
  • Talus / abnormalities*
  • Tarsal Coalition / diagnosis*
  • Tibial Fractures / diagnostic imaging
  • Tibial Fractures / surgery*
  • Treatment Outcome

Supplementary concepts

  • Talonavicular coalition