17 month old dislocated talus

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I am after some insight into a young child I saw today.

17 month old.

Random dislocation of the right talus that occurs barefoot and in shoes.
No history of trauma. The dislocation doesn't hurt the child, they just limp a bit on the right leg until the talus pops back in.

Has anyone seen this before? What sort of treatment modalities do you find are successful? Are there any negative effects later on? Or is there more investigating I need to do?

 

Just a question but how do you know the "talus" is dislocating? What do the plain films look like?

 

Talar disclocation is a serious condition, and usually requires major trauma such as a motor vehicle accident to produce said injury. It usually is associated with ankle fracture and requires open or closed reduction under anaesthesia.

I doubt this accurately reflects what you are describing, but I am trying to keep an open mind.

WHere/how is the talus dislocating? Is it translocating anteriorly out of the ankle mortice? Are you sure that is is a *dislocation*?

I assume, like most toddlers this a hypermobile flatfoot. Is there a suggestion of Ehlers-Danlos of other extreme hypermobility cause?

Any more detail, images or video would be appreciated.

LL

 

When the 'dislocation' occurs the child just walks with their foot everted and leg stiff for a few steps until it 'pops' back in.
It sounds like the talus moves medially or the calcaneus shifts laterally under the talus.
I'll try to get more up here for you as I get it.

 

Coming in a tad late but also interested as to the gait style. Toddlers walk funny and do super odd things.

Plain WB films would be great to post, is the foot rocker bottom at all.

However, I would also be looking up higher, if the leg gets stiff and the foot abducts and they limp, check out the leg creases and buttock folds. Developmental hip dysplasia with a hip popping in and out is a far more common reason for a change in gait with limping in this age.