Foot & Ankle Surgery: Techniques, Reports & Cases (Jan 2022)
Sequelae of subtalar joint dislocations at two level 1 trauma centers: A case series and literature review
Abstract
Traumatic incidences of subtalar joint dislocations are rare, occurring in approximately less than 1% of all traumatic dislocations. These injuries, however, often require prompt treatment due to involvement of skin tenting, open injury, and/or neurovascular compromise. Additionally, functional outcomes may be hampered by high rates of post-traumatic osteoarthritis. Due to the rarity of subtalar joint dislocations, cases are not often reported. A total of 6 acute traumatic subtalar joint dislocations over a 5-year period were included in this case series. Four were caused by high-energy trauma, and two were due to ground level falls. Five (5/6) were medial dislocations and one (1/6) lateral. Three patients had concomitant injuries: one had a posterior process fracture of the talus and two had distal fibular fractures. All six patients had a closed reduction in the operating room under monitored anesthesia care with a standardized post-operative protocol. Three patients were male. Mean patient age, body mass-index, and follow-up was 40.5 years (STD ± 18.7), 32.6 (STD ± 7.6), and 17.7 months (STD ± 9.7), respectively. Average hospital stay was 10.3 days (STD ± 7.9). Five post-operative complications were encountered in 4 patients (66.7%), including post-traumatic arthritis of the subtalar joint in half of the patients (3/6), talonavicular joint arthritis in one patient, and deep wound dehiscence with infection in another patient. All returned to their pre-injury level of work and reactional activity without functional limitations. The recent literature was also reviewed, further emphasizing the lack of data in circulation.
