Subtalar dislocation: Difference between revisions
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*80% medial dislocations | *80% medial dislocations | ||
*25% open, with lateral more likely | *25% open, with lateral more likely | ||
*Associated with fractures ~50% | *Associated with [[foot Fractures|fractures]] ~50% | ||
==Clinical Features== | ==Clinical Features== | ||
| Line 38: | Line 38: | ||
[[Category:Orthopedics]] | [[Category:Orthopedics]] | ||
==Sub-Talar Dislocation== | |||
===Background=== | |||
*Orthopedic emergency | |||
===Evaluation=== | |||
*Plain radiographs usually sufficient | |||
===Management=== | |||
*Immediate ortho consultation and reduction | |||
Revision as of 18:05, 28 September 2019
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
- Foot and toe fractures
- Subtalar dislocation
- Metatarsophalangeal joint sprain (turf toe)
- Acute arterial ischemia
- Calcaneal bursitis
Subacute/Chronic
- Diabetic foot infection
- Peripheral artery disease
- Plantar fasciitis
- Trench foot
- Ingrown toenail
- Paronychia
- Tinea pedis
- Morton's neuroma
- Diabetic neuropathy
Evaluation
- 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