A Rare Case of Fractured Posterior Facet of the Talus in Association With Open Medial Subtalar Dislocation

Abstract

Subtalar or peritalar dislocation is the loss of contact between the articular surface of the talus distally and the calcaneum and navicular. In this paper, a case of open medial type of subtalar dislocation associated with fractured posterior facet of the talus in a 27-year-old man with a history of road traffic accident was reported. Immediate wound irrigation and open reduction under general anesthesia at the emergency room operation theater was successful followed by cast immobilization. At one-year follow-up, the patient was walking and carrying out his daily activities with mild restriction of inversion and eversion movements. Extensive wound debridement followed by immediate reduction and, when required, stabilization are the principal features of management. Open subtalar dislocation is an extremely rare injury and often poses a treatment dilemma. Early debridement and open reduction of the dislocation like in our case can give good functional outcome for an open medial subtalar dislocation at one-year follow-up. Temporary stabilization of dislocation in the form of Kirschner wires maybe needed in some cases only.

Three years follow up of open medial sub-talar dislocation of ankle: a case report

“…Low overall incidence, different manifestations, subtle radiographic findings, and distracting injuries can lead to misdiagnosis and late presentation. 1,3 Subtalar dislocation is noted more often in road traffic accidents than in sports injury because it involves greater velocity of force and higher energy transfer. 1,3,4 In our case there was obvious laceration with exposed underlying soft tissue indicating high energy trauma.…”

“…1,3 Subtalar dislocation is noted more often in road traffic accidents than in sports injury because it involves greater velocity of force and higher energy transfer. 1,3,4 In our case there was obvious laceration with exposed underlying soft tissue indicating high energy trauma.…”

“…These injuries are rare ranging 1-2% of traumatic foot injuries. [1][2][3] Broca classified sub-talar dislocation into 3 types: (1) medial, (2) lateral, and (3) posterior dislocation, classified on basis of position of foot with respect of talus. The medial dislocation is most common type of dislocation, also called 'acquired clubfoot', with an incidence of 65-85% of all dislocation.…”

“…The medial dislocation is most common type of dislocation, also called 'acquired clubfoot', with an incidence of 65-85% of all dislocation. 1 These injuries occur as a result of fall from height, road traffic accident, sports activities, and injuries while running/twisting. Most of the injuries are closed injuries approximately 75% and 25% account for open sub-talar dislocation.…”

“…Most of the injuries are closed injuries approximately 75% and 25% account for open sub-talar dislocation. 1,3 Open dislocation usually occurs due to high energy trauma. Talus is most commonly fractured bone followed by ankle, calcaneum, and navicular bone in high energy trauma/twisting injury.…”