Anterior subtalar dislocation with comminuted fracture of the anterior calcaneal process

Abstract

Anterior subtalar dislocation is a very rare injury. We report a case of an 81-year-old woman who had her right foot injured during a motor vehicle accident. Radiographs showed anterior subtalar dislocation with comminuted fracture of the anterior calcaneal process. The dislocation was closely reduced and protected by a short leg cast. One year postinjury, the patient had only mild pain when walking on uneven ground. There was mild tenderness over the lateral heel. Subtalar motion was mildly painful. There was no pain with ankle motion.

Calcaneal fracture with a concomitant unstable subtalar dislocation: A case report

“…Subtalar joint dislocation is a very uncommon injury that accounts for approximately 1–2% of all joint dislocations [ 11 ]. Isolated dislocations are uncommon but associated fractures have often been described and care has to be taken not to overlook them [ 12 ].…”

“…Subtalar joint dislocation was first described by Judey and Dufaurest in 1811 [ 11 ]. in 1852, Broca classified subtalar dislocations into three types: medial, lateral and posterior, depending on the direction of dislocation [ 12 ].…”

“…in 1852, Broca classified subtalar dislocations into three types: medial, lateral and posterior, depending on the direction of dislocation [ 12 ]. In 1856 Malgaigne and Burguer reported the first case of anterior subtalar dislocation and adjusted the Broca’s classification by adding the anterior dislocation type [ 5 , 7 , 11 ]. The medial dislocation known as “acquired clubfoot deformity” or “basketball foot” is the most common, and accounts for 80–85% of all cases, it occurs with the foot in an inverted plantar flexed position [ 2 , 6 , 14 ].…”

“…For the Treatment of subtalar dislocations, emergency reduction seems to be essential owing to the risk of secondary cutaneous necrosis by ischemia [ 10 ]. To manually reduce the dislocation, the knee should be flexed to decrease the tension exerted by the Achilles tendon, longitudinal traction in the axis of the leg should then be performed on the foot, involving accentuation of the initial deformaty, next, by dorsally flexing the ankle, the opposite maneuver to the deformation should be applied [ 1 , 10 , 11 ]. In 10% of medial subtalar dislocations and 15%–20% of lateral subtalar dislocations, open reduction is necessary because of soft tissue interposition and blocking of the fracture fragments [ 1 ].…”

Case report: irreducible medial subtalar dislocation with incarcerated anterior talar head fracture in a young patient

“…About 80% of all subtalar dislocations occur medially, while 15–20% occur laterally [ 3 ]. Anterior and posterior subtalar dislocations are extremely rare, but both have been reported [ 4 , 5 ].…”