title: Early mobilization after uncomplicated medial subtalar dislocation provides successful functional results.
abstract: BACKGROUND
  Subtalar dislocation is a rare injury, with the medial type occurring in the majority of cases. The period of postreduction immobilization is a matter of controversy. Most studies set the period of immobilization between 4 and 8 weeks. The hypothesis in this study is that a period of 2-3 weeks of immobilization in a cast, followed by early mobilization, could provide better functional results than longer periods of immobilization.
  
  
  METHODS
  During a period of 4 years, eight patients (six men, two women) with mean age of 37.2 years and uncomplicated medial subtalar dislocation were treated in our institution. Immediate reduction under sedation and cast immobilization was provided in all cases. Our rehabilitation protocol consisted of two completed weeks of immobilization and thereafter ankle range-of-motion exercises and partial weight-bearing mobilization. Patients were followed up for a mean period of 3 years. Clinical results were evaluated using the AOFAS Ankle-Hindfoot scale.
  
  
  RESULTS
  All patients achieved almost normal ankle range of motion and good clinical outcome (mean AOFAS score 92.25). No radiographic evidence of arthritis or avascular necrosis of the talus was detected. Two patients complained of mild pain of the hindfoot. All patients returned to daily routine activities in about 2 months from injury.
  
  
  CONCLUSIONS
  Immediate reduction and early mobilization could be key factors for uneventful recovery of uncomplicated medial subtalar dislocation. Multicenter clinical trials are needed for further validation of our initial results.
  
  
  METHODS
  III, prospective clinical series study.
authors.affiliation: Athens General Infirmary Evangelismos, Athens, Greece. lasagrc@hotmail.com
authors.forename: Nikolaos G
authors.initials: NG
authors.lastname: Lasanianos
authors.forename: Dimitrios N
authors.initials: DN
authors.lastname: Lyras
authors.forename: George
authors.initials: G
authors.lastname: Mouzopoulos
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Tsutseos
authors.forename: Christos
authors.initials: C
authors.lastname: Garnavos
mesh_terms: D000328:Adult; D002370:Casts, Surgical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007103:Immobilization; D004204:Joint Dislocations / Q000534:rehabilitation* / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D020127:Recovery of Function; D013380:Subtalar Joint / Q000293:injuries* / Q000502:physiology / Q000601:surgery; D013997:Time Factors