Subtalar dislocation: a narrative review

Abstract

Background Subtalar joint dislocation (1% of all dislocations) is the permanent loss of articular relationships in the talonavicular and talocalcaneal joints, without other involvement of the foot. Dislocation can occur medially (85%), laterally (15%), posteriorly (2.5%) and anteriorly (1%). Reduction can be performed by closed or open technique; lateral dislocations often require open reduction because of inclusion of soft tissues or bone fragments. Lateral dislocations are frequently complicated by bone exposure, risk of infection and associated soft tissues injuries. Aim of the study The aim of this study is to explain main characteristics and to clarify the most important pitfalls of subtalar dislocations. Materials and methods We examined 47 articles published in the last thirty years (389 cases). For each dislocation we reviewed its main characteristics: direction, bone exposure, need for open reduction and for surgical stabilisation, associated injuries and method used for diagnosis. Results Medial dislocations (68.1%) has greater incidence compared to lateral ones (27.7%). Bone exposure (44.5%), associated lesions (44.5%) and need for surgical reduction (48.2%) are much more represented in lateral dislocation than in the others. Conclusions Subtalar dislocations, especially the lateral one, represent a challenge for surgeons. Lateral subtalar dislocation occurs following high-energy trauma often involving associated injuries. Closed reduction could be unsuccessful and patients must undergo surgical reduction. After reduction CT scan is recommended. Our narrative review confirms these findings.

Prospective Study of Clinical Outcome of Closed Subtalar Joint Dislocation, Two Years Follow-Up

“…The lateral dislocation usually occurs due to high-energy trauma and is often associated with other injuries. These patients require open reduction as the closed reduction can be usually unsuccessful (2). In all the types of dislocations, the talonavicular joint gets dislocated first, followed by the talocalcaneal joint.…”