Subtalar Joint Dislocations

1995 ◽  
Vol 16 (12) ◽  
pp. 803-808 ◽  
Author(s):  
Donald R. Bohay ◽  
Arthur Manoli
Keyword(s):  
Current Literature ◽  
Closed Reduction ◽  
Subtalar Joint ◽  
Joint Stiffness ◽  
Cast Immobilization ◽  
Joint Dislocation ◽  
Posttraumatic Arthrosis ◽  
Articular Fractures ◽  
Joint Dislocations ◽  
Short Period

Dislocations of the subtalar joint are rare injuries. The anatomy, pathophysiology, treatment, and prognosis of subtalar joint dislocations have been well described in the literature. The purpose of this paper is to review the current literature on subtalar joint dislocations, as well as outline those aspects of the anatomy, pathomechanics, and treatment pertinent to care of the patient with subtalar joint dislocation. In addition, complications and obstacles to reduction are described. Subtalar joint dislocations, although not common, have increased in frequency over the last decade. Generally, they can be treated successfully with closed reduction and a short period of cast immobilization. The majority of patients will suffer some disability with subtalar joint stiffness the primary complaint. Associated intra-articular fractures increase the risk of posttraumatic arthrosis.

Occult Fractures Following Subtalar Joint Injuries

1996 ◽  
Vol 17 (3) ◽  
pp. 164-169 ◽  
Author(s):  
Donald R. Bohay ◽  
Arthur Manoli
Keyword(s):  
Subtalar Joint ◽  
Joint Stiffness ◽  
Ct Scanning ◽  
Cast Immobilization ◽  
Joint Dislocation ◽  
Essentially Normal ◽  
Articular Fractures ◽  
Joint Dislocations ◽  
Short Period ◽  
Occult Fractures

Subtalar joint dislocations, although not common, have been increasing in frequency over the last decade. Generally, subtalar joint dislocation can be treated successfully with closed reduction and a short period of cast immobilization. The majority of patients will suffer minimal disability, with subtalar joint stiffness as the primary complaint. This report includes four cases of suspected joint dislocation or subluxation with occult intra-articular fractures identified only by CT scan following essentially normal radiographs. Evidence seems to indicate that CT scanning in patients with suspected subtalar joint subluxation or dislocation and normal radiographs is justified.

scholarly journals Isolated Medial Subtalar Joint Dislocation during Soccer (Football) Game: A Case Report and Review of the Literature

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Fekhaoui MR ◽  
◽  
Bassir R A ◽  
Mekkaoui J ◽  
Boufettal M ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Closed Reduction ◽  
Subtalar Joint ◽  
Full Range ◽  
Joint Stiffness ◽  
Young Male ◽  
High Energy ◽  
Joint Dislocation ◽  
Subtalar Dislocation ◽  
First Choice

Ankles injuries are common in sports such as football and soccer and one of the most serious and most rare is the subtalar dislocation. This injury is rare, touches young male patients and usually associated to fractures of the talus, the malleoli or the fifth metatarsal. Usually, this injury occurs in high-energy trauma, but it is very rare in sports injuries. Here we present the case of a 36-year-old male with an isolated Medial Subtalar Joint Dislocation after a severe tackle in a football (soccer) game. We performed a closed reduction under general anesthesia, and then a short-leg cast was applied for 4 weeks, followed by active and passive range of motion. At one-year follow up from trauma, the patient had a pain-free ankle with active full range of motion. For isolated medial subtalar dislocation occurring during sports activities, the first choice is the conservative treatment: Immediate closed reduction needs to be achieved followed by a short immobilization. Active/passive range of motion need to be started early to avoid joint stiffness.

Pseudo Os Trigonum Sign: Missed Posteromedial Talar Facet Fracture

2003 ◽  
Vol 24 (8) ◽  
pp. 642-649 ◽  
Author(s):  
A. Ylenia Giuffrida ◽  
Sheldon S. Lin ◽  
Nicholas Abidi ◽  
Wayne Berberian ◽  
Avril Berkman ◽  
...  
Keyword(s):  
Ct Scan ◽  
Subtalar Joint ◽  
Articular Surface ◽  
Cast Immobilization ◽  
Rare Injury ◽  
Joint Dislocation ◽  
Os Trigonum ◽  
Subtalar Dislocation ◽  
Subtalar Arthritis ◽  
Facet Fracture

Background: Posteromedial talar facet fracture (PMTFF) is a rare injury, sparsely reported in the literature. This article proposes that PMTFF is often left undiagnosed by orthopaedic surgeons and suggests the routine application of advanced radiographic studies (i.e., CT scan) in the recognition of PMTFF. It also evaluates nonoperative management of PMTFF. Methods: After obtaining Institutional Review Board approval, the medical records over a 5-year period (1997–2001) were retrospectively reviewed from the foot and ankle service of a level 1 trauma center, identifying all cases of PMTFF. Charts were reviewed for relevant data. Results of treatment were assessed during follow-up physical examination. Results: Six cases of PMTFF were identified over a 5-year period. All injuries were associated with medial subtalar joint dislocation. Four of six (66%) patients were not initially diagnosed with PMTFF, but instead misdiagnosed as an os trigonum. The remaining two patients had an established diagnosis of PMTFF at the time of initial treatment. All had short leg cast immobilization for medial subtalar dislocation. CT evaluation yielded additional diagnoses in all six patients. All six patients showed a PMTFF. Five patients (83%) revealed persistent subtalar joint subluxation. Five of six (83%) patients required at least one additional procedure as a result of an undiagnosed or nonoperatively treated PMTFF. Four patients underwent subtalar joint fusion, and one patient underwent tibiotalar calcaneal fusion secondary to concomitant ankle/subtalar arthritis. The patient who did not undergo recommended fusion continued to be symptomatic. Conclusions: Diagnosis of PMTFF necessitates a heightened clinical suspicion, especially when a medial subtalar joint dislocation is present. Proper imaging studies, such as coronal CT scan, should be performed after any subtalar dislocation. Timely treatment, in the form of open reduction and internal fixation for large fragments involving the articular surface or surgical excision for smaller fragments, is recommended in order to restore proper anatomy and function of the subtalar joint. This study verifies the significant morbidity associated with an undiagnosed or nonoperatively treated PMTFF.

Fracture-dislocation of the talus in the pediatric patient. An unusual injury

1991 ◽  
Vol 81 (9) ◽  
pp. 495-498 ◽  
Author(s):  
JM Stutz ◽  
JM Karlin ◽  
N Daly
Keyword(s):  
Pediatric Patient ◽  
Closed Reduction ◽  
Subtalar Joint ◽  
Fracture Dislocation ◽  
Joint Dislocation ◽  
Subtalar Dislocation ◽  
Posterior Process ◽  
Fracture Dislocations ◽  
Unusual Injury

Subtalar fracture-dislocations in children are unusual, perhaps because of the greater elasticity of bone in children. The authors have presented a case of medial subtalar dislocation in a 13-year-old boy, accompanied by a rare fracture of the entire posterior process of the talus. This particular fracture has not been previously reported in association with a subtalar joint dislocation, nor has it been reported in a child. The patient was treated successfully by closed reduction of both the dislocation and the fractures.

scholarly journals Closed medial subtalar dislocation: case report and review of the literature

2019 ◽  
Vol 5 (4) ◽  
pp. 732
Author(s):  
Everisto A. Opondo
Keyword(s):  
Subtalar Joint ◽  
High Energy ◽  
Review Of The Literature ◽  
Osteochondral Fracture ◽  
Joint Dislocation ◽  
Wound Debridement ◽  
Subtalar Dislocation ◽  
Joint Dislocations ◽  
Excellent Functional Outcome

A rare case of medial subtalar dislocation is presented and the literature concerning this injury is reviewed. Subtalar joint dislocations are rare and often the result of a high-energy trauma. These talar dislocations represent 1%-2% of all dislocations. A case of uncomplicated medial subtalar joint dislocation managed by closed reduction under anaesthesia with excellent functional outcome is presented. In cases of open subtalar joint dislocation immediate reduction, wound debridement and if necessary (external) stabilization is critical. Up to fifty percent of patients suffering complicated injury are at risk of developing complications such as avascular necrosis of the talus. Other long-term sequelae include osteochondral fracture and subtalar joint instability.

scholarly journals Comparative study on the functional outcome of ligamentotaxis in comminuted fractures of the distal end of radius and with that of conservative means of closed reduction and casting

2017 ◽  
Vol 3 (3) ◽  
pp. 614
Author(s):  
Urampath Sudheer ◽  
Chundarathil Jayaprakash
Keyword(s):  
External Fixator ◽  
Closed Reduction ◽  
Functional Results ◽  
Plaster Cast ◽  
X Rays ◽  
Cast Immobilization ◽  
Score System ◽  
Articular Fractures ◽  
Comminuted Fractures ◽  
Group 2

<p><strong>Background</strong>: Comminuted fractures of lower end of radius most often bring out unsatisfactory outcome, if treated by conservative means of closed reduction and casting. This study was aimed to compare the results of ligamentotaxis in comminuted fractures of the distal end of radius and with that of closed manipulative reduction and plaster cast immobilization.</p><p><strong>Methods</strong>: Patients with comminuted fracture lower end of radius treated by ligamentotaxis or the conservative methods were included in the prospective study. Patients in group l treated by external fixator and in group 2 treated by conservative line of management. Postoperative check X-rays were taken. All the patients were evaluated on 3rd, 6th, 12th and 18th months after surgery. Functional results were assessed by Gartlands point score system and subjected to statistical analysis.</p><p><strong>Results: </strong>Total fifty patients were included in the study. Twenty five were treated by external fixator and the remaining was treated by conservative line of management. Patients underwent ligamentotaxis had 88% excellent results whereas 52% of patients on conservative care had similar results. When the conservative methods gave poor results for severely comminuted fractures, ligamentotaxis could bring out excellent re-orientation of fragments back to near normal alignment.</p><p><strong>Conclusions</strong>: Ligamentotaxis using a distracter is a better method to treat comminuted fractures of lower end of radius. Even though the initial reductions were excellent in a plaster cast, re-displacement rates are very high in a plaster cast. Fractures without intra articular extension always yielded far better results than intra articular fractures.</p>

Displaced Intra-articular Calcaneal Fracture Treated Surgically with Limited Posterior Incision

2000 ◽  
Vol 21 (3) ◽  
pp. 195-205 ◽  
Author(s):  
In-Heon Park ◽  
Kyung-Won Song ◽  
Sung Shin ◽  
Jin-Young Lee ◽  
Tae-Gyun Kim ◽  
...  
Keyword(s):  
Functional Recovery ◽  
Calcaneal Fracture ◽  
Calcaneal Fractures ◽  
Cast Immobilization ◽  
Articular Fractures ◽  
Short Period ◽  
Comminuted Fractures ◽  
Cancellous Screws ◽  
Displaced Fracture

The incidence of calcaneal fracture has been slowly increasing; however, the ideal treatment for displaced intra-articular fracture is not available yet, even though the fracture brings frequent complication and disability. Between April 1991 and March 1998, we treated 103 displaced intra-articular calcaneal fractures of 92 patients surgically with limited posterior incision, modified Gallie approach. There were thirty-seven tongue-type fractures, fifteen tongue-type fractures with moderate comminution, nineteen joint-depression fractures, twenty-nine joint-depression fractures with moderate comminution, and three extensively comminuted fractures. The fracture fragments were fixed mainly with partly threaded small cancellous screws or Steinmann pins without any bone graft. Ankle and subtalar motion was permitted immediately if fixation were stable enough. Otherwise, a short period of cast immobilization was utilized. With a mean follow-up of 28 months (range, 12 to 66 months), eighty six percent of feet had no pain or only occasional pain not requiring medication. Using American Orthopedic Foot and Ankle Society hindfoot score system for assessment, ninety percent of feet rated as good to excellent. We used “Circle draw test” for evaluation of subtalar motion during follow-up visitation and found eight-seven percent of feet showed good to excellent correlation with the functional recovery. We recommend a limited posterior incision for reduction and internal fixation of displaced intra-articular calcaneal fractures. For displaced intra-articular fractures with three or four large fragments without further comminution and without a displaced fracture of the calcaneal cuboid joint, this method is particularly useful. We also recommend a Circle draw test for evaluation of subtalar joint motion as well as an indicator of functional recovery after displaced calcaneal fractures.

scholarly journals Closed-Reduction Techniques for Glenohumeral-, Patellofemoral-, and Interphalangeal-Joint Dislocations

2020 ◽  
Vol 55 (8) ◽  
pp. 757-767
Author(s):  
Cynthia J. Wright ◽  
Barbara A. Brandon ◽  
Edward J. Reisman
Keyword(s):  
Patient Outcomes ◽  
Closed Reduction ◽  
Athletic Trainers ◽  
Interphalangeal Joint ◽  
Scope Of Practice ◽  
Joint Dislocation ◽  
Reduction Techniques ◽  
Joint Dislocations ◽  
Formally Trained ◽  
Selection Of

Joint dislocations account for a small but important portion of all athletic injuries, with most occurring at the glenohumeral, patellofemoral, and interphalangeal joints. Athletic trainers are responsible for managing acute joint-dislocation injuries, which may include performing closed-reduction techniques when appropriate. To achieve optimal patient outcomes, the clinician should be formally trained and skilled in performing various techniques and familiar with the evidence supporting the selection of each technique. In this clinical review, we outline general reduction procedures and then summarize and synthesize the existing literature on common closed-reduction techniques for glenohumeral-, patellofemoral-, and interphalangeal-joint dislocations. When appropriate, the content has been adapted to be specific to the athletic trainer's scope of practice.

Plaster immobilization versus anterior plating for dorsally displaced distal radial fractures in elderly patients in Pakistan

2021 ◽  
pp. 175319342097778
Author(s):  
Muhammad Tahir ◽  
Faridullah Khan Zimri ◽  
Nadeem Ahmed ◽  
Allah Rakhio Jamali ◽  
Ghulam Mehboob ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Randomized Trial ◽  
Closed Reduction ◽  
Primary Outcome ◽  
Locking Plate ◽  
Cast Immobilization ◽  
Distal Radial Fractures ◽  
Level Of Evidence ◽  
Anterior Plating ◽  
Plaster Immobilization

This prospective, multi-centred, randomized trial examined outcomes of 3- and 12-month follow-ups of 159 elderly participants aged more than 75 years with isolated distal radial fractures, treated by anterior locking plate or closed reduction and cast immobilization. The primary outcome was the patient-rated wrist evaluation (PRWE) score. The PRWE score at 12 months was not significantly different between the two groups; however, the radiological outcomes and complications rates were worse in the casting group. Level of evidence: III

Sign in / Sign up

Export Citation Format

Share Document