Subtalar dislocation: Difference between revisions

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==Clinical Features==
==Clinical Features==
===Medial===
*Foot displaced to supination
===Lateral===
*Foot displaced to pronation


==Differential Diagnosis==
==Differential Diagnosis==
{{Foot diagnoses}}
{{Foot diagnoses}}


==Diagnosis==
==Evaluation==
[[File:Subtalar Joint.png|thumb|Talus and subtalar joint]]
[[File:Subtalar Joint.png|thumb|Talus and subtalar joint]]
*Medial d/l - foot displaced to supination; talar head superior to navicular on lateral XR
*Xrays
*Lateral d/l - foot displaced to pronation; talar head inferior to navicular on lateral XR
 
===Medial===
*Talar head superior to navicular on lateral XR
 
===Lateral===
*Talar head inferior to navicular on lateral XR


==Treatment==
==Management==
*Closed reduction and short leg NWB cast first-line, with ortho c/s
*Closed reduction and short leg NWB cast first-line, with ortho consult
*Reduce with ankle plantarflexed, then hindfoot inversion/eversion
*Reduce with ankle plantarflexed, then hindfoot inversion/eversion
*Requires CT after reduction for associated fractures
*Requires CT after reduction for associated fractures
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*[[Talus fracture]]
*[[Talus fracture]]


==Sources==
==References==
*Weatherford B. Talar neck fractures. Orthobullets, last updated 12/19/14. http://www.orthobullets.com/trauma/1048/talar-neck-fractures.  
*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.
*Judd DB, Kim DH. Foot Fractures Frequently Misdiagnosed as Ankle Sprains. Am Fam Physician. 2002 Sep 1;66(5):785-795.
[[Category:Orthopedics]]
==Sub-Talar Dislocation==
===Background===
*Orthopedic emergency
===Evaluation===
*Plain radiographs usually sufficient
===Management===
*Immediate ortho consultation and reduction

Revision as of 13:06, 27 April 2017

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

Foot diagnoses

Acute

Subacute/Chronic

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


Sub-Talar Dislocation

Background

  • Orthopedic emergency

Evaluation

  • Plain radiographs usually sufficient

Management

  • Immediate ortho consultation and reduction