A 64 year old man fell from a ladder directly onto his right foot. Physical examination disclosed a wound on the lateral aspect of the ankle and the midfoot. The talus was completely dislocated and loosely connected to some soft tissue. There were no other apparent injuries except a non-displaced fracture of the fifth metatarsal head. After radiography of the injured area (fig 1A–C), the patient underwent surgery that involved a thorough irrigation of the wound, debridement of avascular skin and soft tissue, and reduction of the talus, followed by fixation by Steinmann pins and primary closure. The leg was placed …