Chronic, Neglected Medial Subtalar Dislocation with Associated Talar and Calcaneal Fractures. A Case Report

Abstract

Subtalar dislocation is a very rare injury that accounts for just approximately 1% of traumatic dislocations. Stan­dard treatment in acute subtalar dislocations is immediate closed reduction and cast immobilization. Early reduction is of key importance and allows avoiding further damage to soft tissues, nerves and blood vessels. Neglected, chronic subtalar dislocations are seen extremely rarely and only a few cases have been reported in the literature to date. Considering the lack of guidelines and very few literature reports relating to the treatment of such injuries, we have decided to present the case of a male patient with a chronic, neglected, closed medial subtalar dislocation of the right foot with associated fractures of the talar and calcaneal bones. The patient was admitted 4 months post trauma to his right ankle joint caused by a fall from a ladder. An open subtalar reduction was performed with arthrodesis of the talocalcaneal joint and the talonavicular joint of the right foot. The treatment was effective and recreated the me­chanical axis of the limb. One year after the surgery, the patient reported no pain and no limitations in everyday functioning, work and activities. At the one-year follow-up, his AOFAS score was 88/100.