The closed medial total subtalar joint dislocation without fracture of ankle case report (Journal of Medical Case Reports)

IntroductionTotal subtalar dislocation without fracture of the ankle is a rare clinical entity; it is usuallydue to a traumatic high-energy mechanism. Standard treatment is successful closed reductionunder general anesthesia followed by non-weight bearing and ankle immobilization with abelow-knee cast for 6 weeks.Case presentationWe present the case of a 30-year-old Moroccan woman who was involved in a road trafficaccident. She subsequently received a radiological assessment that objectified a total subtalardislocation without fracture of her ankle. She was immediately admitted to the operatingtheater where an immediate reduction was performed under sedation, and immobilization in aplaster boot was adopted for 8 weeks. The management of this traumatic lesion is discussedin the light of the literature. Conclusions: Medial subtalar dislocation is a rare dislocation and is not commonly seen as a sports injurybecause 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 isimportant, and closed reduction under general anesthesia is usually successful, oftenfacilitated by keeping the knee in flexion to relax the gastrocnemius muscle. Long-termsequelae include talar avascular necrosis and osteochondral fracture, as well as chronicinstability and pain.