# Rare Combination of Talar Body and Bimalleolar Fractures: A Case Report

## TL;DR

A rare case of talar body and bimalleolar fractures is reported, showing successful treatment and long-term monitoring for complications.

## Contribution

The paper presents a rare clinical case of combined talar body and bimalleolar fractures with a detailed treatment and follow-up.

## Key findings

- The patient achieved a high AOFAS score and minimal pain after treatment.
- MRI detected early signs of osteonecrosis 15 months post-surgery.
- Long-term follow-up is crucial for monitoring post-traumatic arthritis and osteonecrosis.

## Abstract

Background and Clinical Significance: Talar body fractures are very rare injuries, and their occurrence alongside ipsilateral fractures is even more uncommon. We present a case of a 40-year-old male who sustained a talar body fracture combined with an ipsilateral bimalleolar fracture after falling from a height, a combination previously described in only two cases. Case Presentation: Open reduction and internal fixation (ORIF) were performed using dual approaches for both the talus and malleolar fractures. Postoperatively, the rehabilitation protocol included a non-weight-bearing short leg cast, followed by partial weight-bearing with a controlled ankle movement (CAM) boot. At one-year follow-up, the patient achieved an American Orthopedic Foot and Ankle Society (AOFAS) score of 90 and reported minimal pain. Radiographs demonstrated minimal osteoarthritic changes and no signs of osteonecrosis. Nevertheless, early signs of osteonecrosis (ARCO grade I) were detected on MRI 15 months postoperatively. Conclusions: This case highlights the rarity of such injuries, outlines our institution’s treatment approach, and emphasizes the importance of long-term follow-up to monitor for complications such as post-traumatic arthritis and osteonecrosis.