Medial subtalar dislocation

Abstract

Introduction: subtalar dislocations (peritalar or talus cafocalcaneas) consist of dislocation of the talocalcaneal or talonavicular joints respectively. Joint dislocation, therefore, is double. These lesions are extremely rare (only 1 % of all dislocations). They are caused by high energy trauma.

Objective: to present the case of a patient with medial subtalar dislocation of the right ankle, of interest due to the infrequency of this lesion.

Case presentation: male patient, 40-year-old adult and white skin color, with a history of health. During a soccer practice he suffered a fall of his feet and his right ankle was deformed, causing cramps of the great toe, pain and inability to mobility. Physical and imaging test was carried out. He was diagnosed with right medial subtalar dislocation, reduced with the closed manual technique under intrathecal anesthesia. Concluded the rehabilitation, no differences were observed between both feet and ankles in terms of flexor/extensor and pronosupination functions, neither to investment and eversion. The annual clinical and radiological follow-up was maintained for four years, without detecting traumatic sequelae of degenerative, functional, nerve or vascular type.

Conclusions: the incidence of medial subtalar dislocations is high, despite being rare compared to other dislocations. The speed with which its reduction is performed is a key factor for the satisfactory result of the intervention and the recovery of the patient. Imaging is very important to detect associated fractures.