Subtalar dislocation
Background
- Usually high-energy trauma
- 80% medial dislocations
- 25% open, with lateral more likely
- Associated with fractures ~50%
Diagnosis
- Medial d/l - foot displaced to supination; talar head superior to navicular on lateral XR
- Lateral d/l - foot displaced to pronation; talar head inferior to navicular on lateral XR
Treatment
- Closed reduction and short leg NWB cast first-line, with ortho c/s
- Reduce with ankle plantarflexed, then hindfoot inversion/eversion
- Requires CT after reduction for associated fractures
Sources
- 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.