Subtalar dislocation
Background
- Usually high-energy trauma
- 80% medial dislocations
- 25% open, with lateral more likely
- Associated with fractures ~50%
Clinical Features
Medial
- Foot displaced to supination
Lateral
- Foot displaced to pronation
Differential Diagnosis
Evaluation
Talus and subtalar joint
- Xrays
Medial
- Talar head superior to navicular on lateral XR
Lateral
- Talar head inferior to navicular on lateral XR
Management
- Closed reduction and short leg NWB cast first-line, with ortho consult
- Reduce with ankle plantarflexed, then hindfoot inversion/eversion
- Requires CT after reduction for associated fractures
See Also
References
- Weatherford B. Talar neck fractures. Orthobullets, last updated 12/19/14. http://www.orthobullets.com/trauma/1048/talar-neck-fractures.
- Judd DB, Kim DH. Foot Fractures Frequently Misdiagnosed as Ankle Sprains. Am Fam Physician. 2002 Sep 1;66(5):785-795.
Sub-Talar Dislocation
Background
- Orthopedic emergency
Evaluation
- Plain radiographs usually sufficient
Management
- Immediate ortho consultation and reduction
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