Closed subtalar dislocation with non-displaced fractures of talus and navicular: a case report and review of the literature

Abstract

Closed subtalar dislocations associated with talus and navicular fractures are rare injuries. We report on a case of a 43-year-old builder man with medial subtalar dislocation that was further complicated by minimally displaced talar and navicular fractures. Successful closed reduction under general anesthesia was followed by non-weight bearing and ankle immobilization with a below-knee cast for 6 ;weeks. At 3 years post-injury, the subtalar joint was stable, the foot and ankle mobility was in normal limits and the patient could still work as a builder. However, he complained for occasionally mild pain due to the development of post-traumatic arthritis in subtalar and ankle joints. Our search in literature revealed that conservative treatment of all the successfully reduced and minimally displaced subtalar fracture-dislocations has given superior results compared to surgical management. However, even in cases with no or slight fracture displacement, avascular necrosis of the talus or arthritis of the surrounding joints can compromise the final functional outcome.

Anesthesia Management in a Rare Case of Closed Subtalar Dislocation with Posterior Process Talus Fracture: A Case Report and Review of Literature

“…However, in cases which are non-reducible by closed procedure; it is recommended to proceed with open reduction and internal fixation under general anesthesia and a short leg cast immobilization for 4-6 weeks. 7 Optimal management begins with a full assessment of the patient and formulating the anesthesia plan. The strategy for patient care in the perioperative period should be tailored according to the individual and the surgical procedure involved.…”

Subtalar dislocation secondary to a low energy injury

“…Avascular necrosis of the talus is rare given that the talus has not been dissociated from the ankle mortise, therefore most of its blood supply is maintained from the deltoid ligament 6. Most patients will have some degree of pain and stiffness of the subtalar joint and some degree of osteoarthritis following these injuries 7. Closed subtalar dislocation generally has a good functional outcome 7.…”

“…Most patients will have some degree of pain and stiffness of the subtalar joint and some degree of osteoarthritis following these injuries 7. Closed subtalar dislocation generally has a good functional outcome 7. However, when associated with tarsal fractures, higher rates of ankle arthrodesis secondary to traumatic osteoarthritis are observed 8.…”

Medial subtalar dislocation with navicular and posterior talar process fracture: the first report in the literature

“…Fotiadis et al 3 have reported on a medial subtalar dislocation with non-displaced fractures of the talar body and navicular (figure 1). …”