Treatment of closed subtalar joint dislocation: A case report and literature review

Abstract

Subtalar dislocation is defined as a separation of the talocalcaneal and talonavicular articulations, commonly caused by high-energy mechanisms, which include falls from height, motor vehicle crashes, and twisting leg injuries. The dislocations are divided into medial, lateral, anterior, and posterior types on the basis of the direction in which the distal part of the foot has shifted in relation to the talus. The most common type is medial dislocation resulted from inversion injury. Subtalar dislocation may accompany with other fractures. Physical examination must be performed carefully to assess for neurovascular compromise. Most of the subtalar dislocations can be treated with closed reduction under sedation. If this is not possible, open reduction without further delay should be conducted. After primary treatment, X-ray and computed tomography scan should be performed to evaluate the alignment and the fractures. We report a 37-year-old male patient sustained a subtalar dislocation without any bony injury when he was playing football. The patient was successfully treated by closed reduction, and a good alignment was observed at the last follow-up. The pathogenesis and treatment method of this case were analyzed, and the related literature were reviewed, which provided a reference for future clinical treatment.

Closed pure total talar dislocation, open reduction assisted by bone distractor: a case report

“…The overall rate of complications is 20% and is directly related to the severity of injury, open injuries, and the extent of the fractures. Postoperative osteonecrosis of the body of the talus and subtalar stiffness are the most common complications 6. Instability after reduction is another possible complication, which can be avoided by short-term immobilization 7…”

“…Postoperative osteonecrosis of the body of the talus and subtalar stiffness are the most common complications. 6 Instability after reduction is another possible complication, which can be avoided by short-term immobilization.…”

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

“…Patients with this type of dislocation show severe soft tissue damage [ 6 ]. This injury is rare due to strong ligaments connecting the talus and the calcaneum and due to the biomechanical qualities of the ankle [ 2 , 7 ]. In a study conducted by Perugia et al, the AOFAS (American Orthopedic Foot and Ankle Score) scale score showed no statistically significant difference between the medial and lateral STJD at seven-year follow-up [ 8 ].…”

Isolated Medial Subtalar Joint Dislocation during Sports Activities: A Systematic Review of the Literature with Individual Participant Data Analysis

“…The mean age at treatment was 32.54 years, ranging from 16 to 71 years [23,32]. The total number of patients for each study ranged between one and 10 [22,[24][25][26][27][28][29][30][31][32]. In one paper, the affected ankle was not specified (for a total of four patients); of the remaining 22 patients, the right ankle was affected 15 times (68.18%) and the left ankle seven times (31.82%).…”

“…The mean score was 86, with a range from 66 to 100. Good results were obtained with laser therapy and ultrasound therapy after the immobilisation period, using an ankle-brace with crutches and partial weight bearing on the affected limb even during the immobilisation period [23,26] and targeting physiotherapy on the muscular reinforcement of the peroneus longus and the brevis muscles starting after the immobilisation period [22,23,25,26,[31][32][33].…”