title: Closed medial total subtalar joint dislocation without ankle fracture: a case report.
abstract: BACKGROUND
  Total subtalar dislocation without fracture of the ankle is a rare clinical entity; it is usually due to a traumatic high-energy mechanism. Standard treatment is successful closed reduction under general anesthesia followed by non-weight bearing and ankle immobilization with a below-knee cast for 6 weeks.
  
  
  METHODS
  We present the case of a 30-year-old Moroccan woman who was involved in a road traffic accident. She subsequently received a radiological assessment that objectified a total subtalar dislocation without fracture of her ankle. She was immediately admitted to the operating theater where an immediate reduction was performed under sedation, and immobilization in a plaster boot was adopted for 8 weeks. The management of this traumatic lesion is discussed in the light of the literature.
  
  
  CONCLUSIONS
  Medial subtalar dislocation is a rare dislocation and is not commonly seen as a sports injury because it requires transfer of a large amount of kinetic energy. The weaker talocalcaneal and talonavicular ligaments often bear the brunt of the energy and are more commonly disrupted, compared to the relatively stronger calcaneonavicular ligament. Urgent reduction is important, and closed reduction under general anesthesia is usually successful, often facilitated by keeping the knee in flexion to relax the gastrocnemius muscle. Long-term sequelae include talar avascular necrosis and osteochondral fracture, as well as chronic instability and pain.
authors.affiliation: Department of Orthopedic Surgery and Traumatology, B4 UHC Hassan II, Fes, Morocco. Azarkanemohamed02@gmail.com.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Azarkane
authors.forename: Hassan
authors.initials: H
authors.lastname: Boussakri
authors.forename: Abdelghani
authors.initials: A
authors.lastname: Alayyoubi
authors.forename: Mohamed
authors.initials: M
authors.lastname: Bachiri
authors.forename: Abdelhalim
authors.initials: A
authors.lastname: Elibrahimi
authors.forename: Abdelemejid
authors.initials: A
authors.lastname: Elmrini
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D064386:Ankle Fractures; D002370:Casts, Surgical; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging* / Q000601:surgery*; D011859:Radiography; D013380:Subtalar Joint / Q000293:injuries* / Q000601:surgery*; D016896:Treatment Outcome