Summary

Medial subtalar dislocation caused by low energy trauma, if adequately reduced in emergency room, generally heal with conservative treatment, reducing the risk of significant complications.

Abstract

Introduction

Subtalar dislocation is a rare injury characterized by simultaneous dislocation of the distal articulations of talus at both talocalcaneal and talonavicular joints. It can occur in any direction and can produce significant deformity. Most common is medial dislocation. These injuries are frequently associated with fractures, but isolated dislocations are also reported. Methodology: We report 5 cases who were diagnosed as medial subtalar dislocation secondary to low energy injury. After x-ray, prompt closed reduction was performed under sedation. X-ray and CT scan confirms the post-reduction alignment, stability of subtalar joint and rule out any associated fracture. All patients were managed conservatively by non-weight bearing cast for 4 weeks followed by rehabilitation program. At follow up after 1 year, we observed a good clinical and radiological result. Discussion: This case series confirms that mechanism of injury is an important factor in predicting the final result. Subtalar dislocations secondary to high energy trauma are often associated with osteochondral fractures which result in significant complication. Low energy trauma generally doesn’t produce long-term morbidity. Prompt reduction is very important in order to minimize soft-tissue & neurovascular complications, although a CT scan is recommended to identify occult fracture. Conclusion: Subtalar dislocation caused by low energy trauma, if adequately reduced in emergency room, generally heal with conservative treatment, reducing the risk of significant complications.