Closed medial total subtalar joint dislocation without ankle fracture: a case report

Total subtalar dislocation without fracture of the ankle is a rare clinical entity; it is usually due to a traumatic high-energy mechanism. Standard treatment is successful closed reduction under general anesthesia followed by non-weight bearing and ankle immobilization with a below-knee cast for 6...

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Bibliographic Details
Published in:Journal of medical case reports 2014-09, Vol.8 (1), p.313-313, Article 313
Main Authors: Azarkane, Mohamed, Boussakri, Hassan, Alayyoubi, Abdelghani, Bachiri, Mohamed, Elibrahimi, Abdelhalim, Elmrini, Abdelemejid
Format: Article
Language:English
Subjects:
Accidents, Traffic
Adult
Ankle Fractures
Case Report
Case studies
Casts, Surgical
Diagnosis, Differential
Female
Force and energy
Humans
Joint Dislocations - diagnostic imaging
Joint Dislocations - surgery
Radiography
Subtalar Joint - injuries
Subtalar Joint - surgery
Treatment Outcome
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Summary:Total subtalar dislocation without fracture of the ankle is a rare clinical entity; it is usually due to a traumatic high-energy mechanism. Standard treatment is successful closed reduction under general anesthesia followed by non-weight bearing and ankle immobilization with a below-knee cast for 6 weeks. We present the case of a 30-year-old Moroccan woman who was involved in a road traffic accident. She subsequently received a radiological assessment that objectified a total subtalar dislocation without fracture of her ankle. She was immediately admitted to the operating theater where an immediate reduction was performed under sedation, and immobilization in a plaster boot was adopted for 8 weeks. The management of this traumatic lesion is discussed in the light of the literature. Medial subtalar dislocation is a rare dislocation and is not commonly seen as a sports injury because it requires transfer of a large amount of kinetic energy. The weaker talocalcaneal and talonavicular ligaments often bear the brunt of the energy and are more commonly disrupted, compared to the relatively stronger calcaneonavicular ligament. Urgent reduction is important, and closed reduction under general anesthesia is usually successful, often facilitated by keeping the knee in flexion to relax the gastrocnemius muscle. Long-term sequelae include talar avascular necrosis and osteochondral fracture, as well as chronic instability and pain.
ISSN:1752-1947
1752-1947
DOI:10.1186/1752-1947-8-313