Subtalar joint is a complex joint in hindfoot formed by the talus superiorly and the calcaneus and navicular inferiorly. Subtalar dislocations are high-mechanism injuries, which are caused by simultaneous dislocation of both talonavicular and talocalcaneal joints, without major fracture of the talus. They are usually classified as medial (most common), lateral, anterior and posterior dislocations, based on the position of foot in relation to talus and the indirect forces that have been applied to cause this significant injury. They are usually diagnosed by X rays, but computed tomography and magnetic resonance imaging can be used to identify associated intra-articular fractures and peri-talar soft tissue injuries respectively. Majority being closed injuries, can be managed in ED by closed reduction and cast immobilisation, but if they are open, have poor outcomes. Complications that ensue open dislocations are post-traumatic arthritis, instability and avascular necrosis.
In this paper we discuss a novel case in which a patient had a comorbid diagnosis of KBG syndrome and Scheuermann’s disease. The patient was a 14-year-old boy, referred to orthopaedics for assessment of his spinal deformity. Initial assessment revealed that he had a rib prominence on his right side, which was corrected upon bending forward. SLR examination indicated significantly tight hamstrings. Plantars were upturning, but other reflexes were normal. He had kyphosis measuring up to 59.4 degrees. MRI of the spine depicted features of classic Scheuermann’s disease, from D6-D10. The patient was given conservative treatment consisting of physical therapy and postural training. He remained asymptomatic during the course of a 5-year follow-up period. This case is unique due to the comorbidity of Scheuermann’s disease and KBG syndrome, which has never been reported in the literature. This case report suggests that routine spinal screening in cases of KBG syndrome would contribute to a better understanding of treatment and diagnosis. Keywords: KBG syndrome, Scheuermann’s disease
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