Subtalar dislocation: two cases requiring surgery and a literature review of the last 25 years

Hoexum, Frank; Heetveld, Martin J.

doi:10.1007/s00402-014-2040-6

Cited by 50 publications

(69 citation statements)

References 68 publications

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“…In these cases, open reduction is required. Our treatment guidelines, which include an immediate reduction and immobilization for 6 weeks with a short leg cast, correspond to current recommendations [2] [14] [17]- [19]. In cases with persistent instability, we applied a K-wire transfixation of the talo-calcanear and talo-navicular joints.…”

Section: Discussionmentioning

confidence: 96%

Subtalar Dislocation: Long-Term Follow-Up and CT-Morphology

Hoelscher-Doht

Frey²,

Kiesel³

et al. 2015

OJO

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Introduction: Although rare, subtalar dislocations are severe injuries with long-term alterations such as clinical dysfunction or painful posttraumatic arthritis. The objective of this study was to investigate long-term morphological changes of subtalar dislocations and to correlate them to clinical function. Based on the conclusions, suggestions for therapy guidelines were made in order to improve the functional outcome. Methods: Twenty-two patients (12 with a medial, 9 with a lateral and 1 with an anterior dislocation) were re-examined with an average follow-up time of 10 years. Radiological results of a computer tomography examination of the hindfoot were related to the clinical outcome, and both were discussed in the context of further parameters, such as additional injuries, time until reduction, and post-reduction treatment. Results: Additional injuries were found to affect the clinical outcome and/or the radiological changes. Predictive factors for limited range of motion were severe skin trauma and traumatic brain injuries. Factors that predicted both poor clinical function and clear signs of arthritis included complex talus, ankle and calcaneus fractures, long time until reduction, and infection. Conclusions: In many cases, radiological results can be correlated to clinical outcomes. However, the modulating effects of additional injuries should be considered when planning therapy. In cases with additional fractures of the talus and the calcaneus, suffering pain may be reduced by an early arthrodesis of the talo-calcanear joint. In cases involving a long stay on an intensive care unit, early functional treatment by passive motion should be discussed in special cases to improve the clinical outcome.

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Section: Discussionmentioning

confidence: 96%

Subtalar Dislocation: Long-Term Follow-Up and CT-Morphology

Hoelscher-Doht

Frey²,

Kiesel³

et al. 2015

OJO

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“…Occasionally, direct soft pressure on the head of the talus can make reduction more easy [25]. In the event that the reduction is not achieved by interposition of bone or soft parts [8,19,20,27,28], multiple attempts with brute force should not be undertaken under any circumstances, and urgent open reduction should be considered [1,18] since, otherwise, we can cause iatrogenic injuries such as fractures of the talus or neurovascular injuries [6].…”

Section: Discussionmentioning

confidence: 99%

“…They are infrequent injuries due to the inherent stability of the talus, representing 1% of total dislocations [1,2]. They occur more frequently in middleaged adult male patients and, in most cases, they are associated with fractures of the malleoli or other bones of the foot, being exceptional their presentation as an isolated injury [3].…”

Section: Introductionmentioning

confidence: 99%

Untitled

2018

MOJOR

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“…En general, la reducción se realiza fácilmente en un paciente sedado si no hay obstáculos (además de los óseos) importantes, como interposición del retináculo extensor, tendones peroneos o tibial posterior. 4,8 En algunos estudios, se comunicó que la reducción manual era imposible en aproximadamente el 10% de las lesiones mediales y el 15-32% de las laterales. 9 La reducción de emergencia es esencial para evitar la necrosis cutánea producida por la cabeza del astrága-lo.…”

Section: Discussionunclassified

“…3 La dirección en la que el pie se encuentra luxado determina los tipos medial, lateral, posterior o anterior. 4 La luxación medial es la más frecuente y representa aproximadamente el 80% de los casos reportados. 5 Las luxaciones peritalares laterales son menos frecuentes (17%) y las posteriores (2,5%) y las anteriores son raras (1%).…”

Section: Introductionunclassified

Presentación inusual de una fractura-luxación peritalar. [Unusual presentation of a peritalar fracture dislocation]

Vecchio

Codesido

Uzair

et al. 2018

Rev. Asoc. Arg. Ort. y Traumatol

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ResumenUna luxación peritalar implica la ruptura simultánea de las articulaciones talocalcánea y talonavicular. Es relativamente poco frecuente y representa aproximadamente del 1% al 1,5% de todas las lesiones traumáticas del pie. La luxación medial es la más frecuente (alrededor del 80% de los casos comunicados). Las luxaciones peritalares laterales son menos frecuentes (17%) y las posteriores (2,5%) y anteriores son raras (1%). Aproximadamente el 55% del subtipo medial y el 72% del subtipo lateral se asocian con fracturas. Se presenta el caso de una mujer de 36 años que sufrió un traumatismo indirecto practicando kitesurf al caerse de la tabla tratando de evitar un accidente. Sufrió una luxación peritalar lateral con fracturas de escafoides tarsiano, calcáneo y peroné asociadas. A los tres días, se intentó una reducción cerrada y a los seis días, se realizó la cirugía. Se recomienda un diagnóstico precoz de las luxaciones peritalares y un rápido reconocimiento de las fracturas asociadas e infrecuentes, con el fin de evitar complicaciones frecuentes.Palabras clave: Calcáneo; fractura-luxación; peritalar. Nivel de Evidencia: IV Unusual presentation of a peritalar fracture dislocation AbstractA peritalar dislocation involves simultaneous disruption of the talocalcaneal and talonavicular joints. It is relatively uncommon and account for approximately 1% to 1.5% of all traumatic foot injuries. Medial dislocation is the most frequent type accounting for approximately 80% of reported cases. Lateral peritalar dislocations are less common (17%), and posterior (2.5%) and anterior dislocations are rare (1%). Approximately 55% of medial and 72% of lateral subtypes are associated with fractures. We report the case of a 36-year-old woman who suffered an indirect traumatism during kitesurf practice, after falling from the kite-board trying to avoid an accident. She presented a lateral peritalar dislocation with associated navicular, calcaneal and fibular fractures. A closed reduction was attempted three days from trauma. Six days after the lesion, surgery was performed. We recommend an early diagnosis of peritalar dislocations and a correct recognition of infrequent fractures to avoid usual complications.

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Subtalar dislocation: two cases requiring surgery and a literature review of the last 25 years

Abstract: 4.

Cited by 50 publications

References 68 publications

Subtalar Dislocation: Long-Term Follow-Up and CT-Morphology

Subtalar Dislocation: Long-Term Follow-Up and CT-Morphology

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Presentación inusual de una fractura-luxación peritalar. [Unusual presentation of a peritalar fracture dislocation]

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