Abstract
Dislocation of the fourth and fifth tarsometatarsal joints in conjunction with lateral subtalar dislocation is a rare occurrence. Little is known about the mechanism of injury, the appropriate treatment for this condition, and its ultimate prognosis. In this report, we describe this atypical presentation in a middle aged, otherwise healthy male who sustained a trivial twisting injury to the ankle when he slipped and fell on ice. Open reduction and K-wire fixation were necessary to affix the lateral tarsometatarsal and talonavicular joints. At one year postoperatively, he was able to return to his preinjury occupation with mild to moderate pain with prolonged walking. His Foot and Ankle Disability Index and American Orthopaedic Foot and Ankle Society scores were 64 and 65 points, respectively. Surgical intervention resulted in a stable plantigrade foot; however, the patient had early radiographic evidence of posttraumatic arthritis in the midfoot joints at one-year follow-up.
Highlights
Subtalar dislocations are relatively uncommon injuries to the foot and ankle, accounting for 1% to 2% of all dislocations and 15% of peritalar injuries
We affirm the recommendations of Bibbo et al that computed tomography (CT) scans should be obtained in all subtalar dislocations to evaluate injuries not recognized by plain radiographs alone [14]
Subtalar dislocations are complex injuries and the final outcomes often are affected by a number of patient- and injury-related factors
Summary
Subtalar dislocations are relatively uncommon injuries to the foot and ankle, accounting for 1% to 2% of all dislocations and 15% of peritalar injuries. Multiple authors have reported a high frequency of associated injuries in almost 88% of cases, such as fractures of the medial and lateral malleolus, talar neck, posterior process of talus, anterior process of calcaneus, and navicular [4, 8,9,10,11,12,13]. We affirm the recommendations of Bibbo et al that computed tomography (CT) scans should be obtained in all subtalar dislocations to evaluate injuries not recognized by plain radiographs alone [14]. Some of these injuries may alter treatment or portend a worse prognosis
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