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Bilateral congenital subtalar dislocation: a case report.

Robert A Kaufmann1, Richard Davidson, James McCarthy

  • 1Shriners Hospitals for Children, Philadelphia, PA 19140, USA.

Clinical Orthopaedics and Related Research
|April 16, 2002
PubMed
Summary
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This study details a rare case of bilateral congenital subtalar dislocation in a young boy, successfully treated with surgical intervention and prolonged orthotic management. The patient achieved pain-free ambulation and normal function, with no recurrence at 10-year follow-up.

Area of Science:

  • Orthopedics
  • Pediatric Surgery
  • Medical Case Reports

Background:

  • Congenital subtalar dislocation is a rare condition affecting foot and ankle development.
  • Early diagnosis and intervention are crucial for optimal outcomes in pediatric orthopedic conditions.

Observation:

  • A 2.5-year-old boy presented with fixed bilateral congenital subtalar dislocations, ambulating on the medial aspects of his feet and experiencing pain.
  • Physical examination revealed a thick fibrous band between the talus and calcaneus laterally.

Findings:

  • Surgical open reduction and pinning of the bilateral subtalar joints, with soft tissue release and tendon lengthening, were performed.
  • Postoperative management included casting and 8 years of rigid ankle-foot orthoses (AFOs).
  • At 10-year follow-up, the patient was brace-free for 2 years, exhibiting normal subtalar range of motion, pain-free ambulation, and participation in sports.

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Implications:

  • This case highlights the potential for successful surgical correction and long-term functional recovery in rare congenital foot deformities.
  • The findings suggest that aggressive surgical and orthotic management can lead to excellent outcomes, even in severe presentations.
  • This report contributes to the literature by documenting a previously unreported congenital subtalar dislocation, emphasizing the importance of recognizing and treating such conditions.