Subtalar joint dislocation

Subtalar joint dislocation

Involves both talocalcaneal and talonavicular articulations uncommon (<1% of all dislocations). Most due to high energy impact (eg motor vehicle accident; fall from height).10% are open. Medial dislocation is most common (~80%)  looks like a clubfootClinical features: Pain; obvious deformity (may be masked by swelling); foot appears shorter; foot is in equinus; can palpate head of talus anterior to lateral malleolus, if medial dislocation X-ray – obvious, but may be missed if only ankle x-rays takenManagement: Immediate attempt at closed reduction, preferably under general anaesthesia – (to avoid avascular necrosis of talus and skin necrosis)  nonweightbearing cast for 4-6 weeks If closed unsuccessful  open reductionComplications: Short term – skin necrosisLong term: • avascular necrosis of talus • arthritis • stiffness (common finding)