title: Isolated Acute Traumatic Subtalar Dislocations: Review of 13 Cases at a Mean Follow-Up of 6 Years and Literature Review.
abstract: Isolated acute traumatic subtalar dislocations are quite rare. They correspond to talotarsal dislocation, including the talonavicular and talocalcaneal joints. The purpose of the present study was to evaluate the functional and radiologic outcomes of the treatment of acute traumatic isolated subtalar dislocations. The present retrospective study included 13 patients who had sustained isolated subtalar dislocations during a 10-year period. Of the 13 cases, 10 (76.9%) were medial dislocations and 3 (23.1%) were lateral dislocations. All the patients underwent immediate closed reduction under anesthesia followed by immobilization. No open reduction was required. The mean follow-up period was 72.6 (range 24.4 to 124.8) months. The mean American Orthopaedic Foot and Ankle Society ankle-hindfoot score was 80.1 of 100 (range 66 to 90). The score result was good in 69% of cases and poor in 31% of cases. The subtalar mobility was reduced for 8 (61.5%) patients and significantly affected the American Orthopaedic Foot and Ankle Society score (p = .002). Subtalar osteoarthritis was present in 6 (46.1%) cases with talonavicular osteoarthritis in 3 (23.1%) cases. No cases of avascular necrosis of the talus were noted. In accordance with the published data, the prognosis of isolated acute traumatic subtalar dislocations is favorable. Medial dislocations are more frequent than lateral dislocations. Emergent closed reduction makes it possible to remove soft tissue injuries. The risk of post-traumatic subtalar osteoarthritis is significant, even without an initial subtalar lesion. A postreduction computed tomography scan will enable the diagnosis of osteochondral lesions.
authors.affiliation: Orthopaedic and Traumatology Surgeon, Department of Orthopaedics and Traumatology, University Hospital of Poitiers, Poitiers, France. Electronic address: ruhlmann_francois@yahoo.fr.
authors.forename: François
authors.initials: F
authors.lastname: Ruhlmann
authors.affiliation: Orthopaedic and Traumatology Surgeon, Department of Orthopaedics and Traumatology, University Hospital of Poitiers, Poitiers, France.
authors.forename: Camille
authors.initials: C
authors.lastname: Poujardieu
authors.affiliation: Orthopaedic and Traumatology Surgeon, Sussex Orthopaedic National Health Services Treatment Centre, Haywards Heath, West Sussex, United Kingdom.
authors.forename: Joel
authors.initials: J
authors.lastname: Vernois
authors.affiliation: Orthopaedic and Traumatology Professor, Department of Orthopaedics and Traumatology, University Hospital of Poitiers, Poitiers, France.
authors.forename: Louis-Etienne
authors.initials: LE
authors.lastname: Gayet
mesh_terms: D000208:Acute Disease; D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D013380:Subtalar Joint / Q000293:injuries* / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
keywords: acute traumatic dislocation; osteoarthritis; subtalar joint; talocalcaneal joint; talonavicular joint; talotarsal joint; talus