(—THIS SIDEBAR DOES NOT PRINT—) DESIGN GUIDE QUICK START (cont.) Transcalcaneal Talonavicular Dislocation Secondary to a Boating Explosion: A Case Report This PowerPoint 2007 template produces a 36”x60” presentation poster. You can use it to create your research poster and save 3 How to change the template color theme valuable time placing titles, subtitles, text, and graphics. Elbys Era, DPM ABFAS ¹ Martina Randall, DPM ² Jasmine Cruz, DPM You can easily change the color theme of your poster by going to the DESIGN menu, click on COLORS, and choose the color theme of your We provide a series of online answer your poster production ¹Attending Physician, Palmetto General Hospital Department of Orthopedics- Podiatric Medicine, Hialeah, FL; Era and Ankle, Miami, FL choice. You can also create your own color theme. questions. To view our template tutorials, go online to PosterPresentations.com and click on HELP DESK. ²Resident Foot and Ankle Surgery PGY-3, Palmetto General Hospital Department of Orthopedics- Podiatric Medicine, Hialeah, FL 3Resident Foot and Ankle Surgery PGY-2, Palmetto General Hospital Department of Orthopedics- Podiatric Medicine, Hialeah, FL When you are ready to print your poster, go online to PosterPresentations.com Discussion Statement of Purpose and Review Case Study Continued - Surgical Procedure Stage 1 Need assistance? Call us at 1.510.649.3001 The calcaneus is the most commonly fractured tarsal with a great Intraoperative access to the talonavicular joint was gained via a dorsal-medial incision, with the talar head visualized deep to the spring ligament. Opposing traction Transcalcaneal Talonavicular Dislocations (TCTND) are challenging due to You can also manually change the color of your background by going to preponderance of intra-articular involvement occurring secondary to falls from was applied to the calcaneus and forefoot along with manual manipulation of the talar head which successfully reduced the talonavicular joint. The posterior tibial fracture complexity, unclear vascular compromise and soft tissue VIEW > SLIDE MASTER. After you finish working on the master be sure a height 1-2. Plantar dislocation of the talus on the navicular, accompanied with pulse was obtained immediately after the deformity reduction. Intraoperative fluoroscopy confirmed the reduced position and two crossing transarticular 0.62 complications. To date there are limited studies depicting this injury pattern, to go to VIEW > NORMAL to continue working on your poster. QUICK START an intra-articular comminuted calcaneal fracture are the hallmark injuries kirschner wires were transfixed across the talonavicular joint to maintain the alignment. Copious irrigation was followed by a layered primary closure. with results and treatment greatly varying 3-10.

Zoom in and out sustained in the uncommon but severe Transcalcaneal Talonavicular How to add Text dislocation (TCTND) 3-9 . 4 As you work on your poster zoom in and out to the level that is Figures 2a & 2b- Pre Op X-Ray Figure 3a & 3b- Pre Op CT The largest study to date by Ricci et al reports a series of 8 patients with The template comes with a number of pre- more comfortable to you. Go to VIEW > ZOOM. TCTND of which 5 were open grade 3 Gustilo Anderson with 3 lacerations to formatted placeholders for headers and text Here we present a unique case of TCTND resulting from a boat explosion. To the posterior tibial artery. All injuries were treated with staged/delayed open blocks. You can add more blocks by copying and Title, Authors, and Affiliations our knowledge this is the first reported civilian case of TCTND sustained by a reduction and internal fixation of the calcaneus and fusion of the subtalar joint, pasting the existing ones or by adding a text box Start designing your poster by adding the title, the names of the authors, and reverse mechanism of inferior implosion in a cephalad direction rather than after provisional stabilization. The injuries resulted in 4 patients with chronic from the HOME menu. the affiliated institutions. You can type or paste text into the provided boxes. axial loading. Our Injury pattern mimics that of Coltart et al, which were the osteomyelitis, which went on to various levels of (2 below knee, 1 The template will automatically adjust the size of your text to fit the title result of land-mine explosions during WWII 10. Incidence of this injury symes, and 1 talectomy). Coltart et al 10 reported on talar injuries associated Text size box. You can manually override this feature and change the size of your text. pattern is rare, as few reports are seen in literature, of which many are with calcaneal fractures from 1940-1945 secondary to land-mines injuries. In Adjust the size of your text based on how much content you have to associated with a high rate of complications as morbidity is owed to infection, this study 3 of the 5 patients went on to below knee amputation. present. The default template text offers a good starting point. Follow TIP: The font size of your title should be bigger than your name(s) and soft tissue compromise, and calcaneal deformation 3-9. Here we highlight this the conference requirements. institution name(s). rare mechanism, fracture pattern, treatment course and outcome. The present case highlights the immense force generated with combustion of a

gas tank, as it mimics the force of land-mines recorded over 50 years ago. How to add Tables

Case Study A circular external fixator was then applied to the right lower extremity to immobilize the ankle and calcaneal fractures, while concomitantly creating arthrodiastasis Here we report the first case of a civilian TCTND as the result of an To add a table from scratch go to the INSERT menu and of the ankle and subtalar joints. This was performed via arch- wire technique allowing for manipulation of the calcaneal tuber in a posterior fashion to re-establish the explosion. Meticulous preservation and management of this precarious soft click on TABLE. A drop-down box will help you select rows An otherwise healthy 36- year-old male presented to the Emergency calcaneal height and adjust the varus attitude. This initial fixation method was utilized to allow the soft tissue envelope to heal, while maintaining ankle and subtalar tissue envelope played a profound role in our surgical selection and staging and columns. Department after being involved in a boat explosion. The patient was launched You can also copy and a paste a table from Word or another PowerPoint Adding Logos / Seals joint congruity, and calcaneal architecture (Figures 4a, 4b). The patient was monitored post-operatively and discharged non weightbearing, with instructions to follow protocol. In our experience, early reduction and stabilization with joint into the air, after combustion of the gas tank under the floorboard. On physical document. A pasted table may need to be re-formatted by RIGHT- Most often, logos are added on each side of the title. You can insert a logo by up in the office. diastasis via external fixation demonstrated a two-fold benefit; allowing for examination there was circumferential rearfoot ecchymosis, medial midfoot CLICK > FORMAT SHAPE, TEXT BOX, Margins. dragging and dropping it from your desktop, copy and paste or by going to optimal soft tissue conditions to support definitive reconstruction, while skin tenting, with no violation of skin envelope (Figure 1a, 1b). A void was INSERT > PICTURES. Logos taken from web sites are likely to be low quality maintaining subtalar joint congruity and calcaneal posture. With staged noted proximal to the navicular, with the talar head palpated plantar-medially. Figures 4a & 4b- Post Op X-Ray Figures 5a & 5b- Post Op X-Ray Graphs / Charts when printed. Zoom it at 100% to see what the logo will look like on the final surgical execution we were able to restore the architecture of the rearfoot and poster and make any necessary adjustments. Tremendous edema made vascular inspection challenging. Doppler You can simply copy and paste charts and graphs from Excel or Word. recreate a functional, plantigrade foot in an injury traditionally associated with examination revealed triphasic dorsalis pedis pulse with the posterior tibial Some reformatting may be required depending on how the original high morbidity. Despite our results, patients with this injury must be counseled TIP: See if your company’s logo is available on our free poster templates pulse non-auditory. document has been created. page. to expect functional limitations, chronic pain and/or amputation as the severity

of this injury is of critical importance. How to change the column configuration Radiographic evaluation (Figures 2a, 2b) revealed a severe calcaneal fracture Photographs / Graphics References RIGHT-CLICK on the poster background and select LAYOUT to see the You can add images by dragging and dropping from your desktop, copy and and talonavicular dislocation with the talus plantar-medial to the navicular. column options available for this template. The poster columns can paste, or by going to INSERT > PICTURES. Resize images proportionally by Proximal segmental fracture of the fibula was seen, with relatively anatomic 1. Giannestras N, Sammarco GJ. Fractures and dislocations in the foot. In: Rockwood CA Jr, Green DP, editors. Fractures. Vol 2. Philadelphia: JB Lippincott; 1975. p 1400-89. also be customized on the Master. VIEW > MASTER. holding down the SHIFT key and dragging one of the corner handles. For a alignment. Computed Tomography (CT) imaging demonstrated intra-articular professional-looking poster, do not distort your images by enlarging them depression and comminution of calcaneus with the talus embedded within the 2. DeLee JC. Fractures and dislocations of the foot. In: Mann RA, Coughlin MJ,editors. Surgery of the foot and ankle. 6th ed, vol 2. St. Louis: Mosby; 1993. p 1465-703. disproportionally. How to remove the info bars posterior facet and calcaneal body (Figure 3a). Additionally, fracture lines 3. Ebraheim NA, Salvolaine ER, Paley K, Jackson WT. Comminuted fracture of the calcaneus extended into the anterior calcaneus, and sustentacular fragment (Figure 3b). If you are working in PowerPoint for Windows and have finished your associated with subluxation of the talus. Foot Ankle 1993;14:380–4. poster, save as PDF and the bars will not be included. You can also

4. Ricci WM, Bellabarra C, Sanders R. Transcalcaneal navicular dislocation. J Bone Joint Surg delete them by going to VIEW > MASTER. On the Mac adjust the Page- Figure 1a & 1b- Clinical Case Study Continued - Surgical Procedure Stage 2 84: 557-561, 2002. Setup to match the Page-Setup in PowerPoint before you create a PDF. 5. Lwin CTT, Garde A, Ribbans WJ. Closed transcalcaneal fracture with talonavicular Twenty days after initial surgical intervention soft tissue stability was achieved and the patient was brought to the operating room for removal of external fixation subluxation. Foot Ankle Surg 13: 150-153, 2007 You can also delete them from the Slide Master. follow by open reduction and internal fixation of the right calcaneus. A traditional lateral extensile approach was used with a lateral calcaneal plate and screw fixation. ORIGINAL DISTORTED 6. Galanakos, Spyridon P., Vassilios Papathanasiou, and Ioannis P. Sofianos. "Transcalcaneal Corner handles A non-traditional posterior to anterior screw was used to aid in our reduction of the posterior tuber to the sheared constant sustentacular fragment. Talonavicular Dislocation Associated with an Open Comminuted Calcaneal Fracture: A Case Save your work Report. Clinics in Podiatric Medicine and Surgery 28.4 (2011): 763-67 Save your template as a PowerPoint document. For printing, save as Image Quality Check 7. Kamath RP, Chandran P, Nihal A. Transcalcaneal talonavicular dislocation. Foot Ankle Surg PowerPoint or “Print-quality” PDF.

Zoom in and look at your images at 100% magnification. If they look good 13: 147-149, 2007 Results they will print well. 8. Cui, Jian, Liang Sun, Jun Di, Wen-Zhao Xing, Chun-Pu Zhang, and Ying-Ze Zhang.

Closed reduction of the talonavicular dislocation was unsuccessful, and with The patient was placed in a below knee OCL splint at 90 degrees for 2 weeks non weightbearing. At week 2 the patient was transitioned into a CAM boot, remaining "Calcaneal Fracture Combined with Dislocation of the Talonavicular Articulation and Student discounts are available on our Facebook page.

Subluxation of the Ankle Joint. Orthopaedic Surgery 2.3 (2010): 237-40. NWB for another 4 weeks. The patient began physical therapy, stretching and ROM exercises at week 6 with partial weightbearing in a CAM boot and crutches. At 14 Go to PosterPresentations.com and click on the FB icon. combined suspected compromise of the posterior tibial artery, the patient was 9. Ventham, N. T., Phadnis, J., Sujenthiran, A., Trompeter, A. J., & Ramesh, P. (2013). Isolated immediately prepared for the operating room with the intention to: 1. evaluate weeks X-rays showed consolidation of the fracture fragments with acceptable alignment (Figures 5a, 5b) and patient weightbearing in sneakers. Clinically subtalar Transcalcaneal Talonavicular Dislocation: A Severe Injury Related to a Low-energy Mechanism. and re-establish vascularity 2. anatomically reduce the talonavicular joint 3. joint and talonavicular range of motion was decreased with ankle joint range of motion without limitations. At 12 months the patient remains ambulating with no pain JFAS, 52(3), 367-369. doi:10.1053/j.jfas.2012.12.015

stabilize fracture components and establish arthrodiastasis of the subtalar joint. or restrictions. 10. Coltart WD. Aviator’s Astragalus. J Bone Joint Surg Br 1952;34:545–66. © 2015 PosterPresentations.com

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