Subtalar (peritalar) dislocation is an uncommon injury of the foot in which the subtalar and the talonavicular joints are dislocated simultaneously. 1-7,10-16 Its incidence has been estimated to be approximately 1% of all dislocations 7,12,14 and fewer than 2% of all major joint dislocations.4 Most often, the foot is dislocated medially to the talus, although lateral, anterior, and posterior dislocations can also occur. 16 The patient in this report sustained the medial type of this injury twice in the same foot. CASE REPORTA 20-year-old male patient injured his right foot while playing basketball. Examination in our accident unit revealed an inversion deformity of this foot. Roentgenograms taken before any attempt for reduction showed a medial subtalar and talonavicular dislocation without fracture (Fig. 1). Under general anesthesia, reduction of the dislocation was attempted. The success of the manipulations was confirmed by roentgenogram taken after the application of a short leg cast (Fig. 2). The extremity was immobilized for 8 weeks. From the 5th week and with the use of a removable back slab, active exercises were begun and full weightbearing was allowed 10 weeks after the reduction. At follow-up examination 6 months later, the patient had almost normal range of motion of the subtalar joint and had no pain in the foot. He returned gradually to his previous athletic activities and played professional basketball without any problem in his foot.Five years later, he again twisted his right ankle while playing basketball and sustained a similar closed injury. New roentgenograms revealed a subtalar dislocation almost identical to the first one (Fig. 3). Reduction was obtained again by manipulations under general anesthesia. As with the first injury, the leg was immobilized in a short leg cast (Fig. 4) for 8 weeks, but the active and passive Figure 1. Roentgenograms (A and B) of the right foot after the first injury, revealing a subtalar dislocation.exercises were started only after the final removal of the cast. Full weightbearing was allowed 3 months after the reduction. At followup 12 months later, the patient did not complain of any pain in the foot; however, at that time significant limitation of the range of motion of the subtalar joint was noted. Despite this stiffness, he was able to return successfully to top-level basketball.
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