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Open subtalar dislocation treated by distractional external fixation.

Sasa Milenkovic1, Mile Radenkovic, Milorad Mitkovic

  • 1Clinic for Orthopaedic Surgery and Traumatology Nis, Serbia and Montenegro. sasa65@bankerinter.net

Journal of Orthopaedic Trauma
|September 28, 2004
PubMed
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Subtalar dislocation is a rare, high-energy injury. A distractional external fixator aided wound healing and talus unburdening in a Gustilo type IIIB open subtalar dislocation case.

Area of Science:

  • Orthopedic surgery
  • Trauma care

Background:

  • Subtalar dislocation is a rare injury, often resulting from high-energy trauma.
  • Gustilo type IIIB open fractures present significant management challenges.

Observation:

  • A 33-year-old man sustained a Gustilo type IIIB open subtalar dislocation from a 4m fall.
  • A Mitkovic distractional external fixator was applied for 6 weeks for wound healing and talus unburdening.
  • The patient underwent physical therapy with progressive weight-bearing over 3 months.

Findings:

  • At 24 months post-injury, the patient exhibited normal gait with minimal pain during prolonged activity.
  • Radiographs and MRI showed no signs of avascular necrosis or posttraumatic arthritis.
  • Ankle range of motion was 5° dorsiflexion and 45° plantar flexion, with moderately limited subtalar motion.

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Implications:

  • Distractional external fixation may facilitate wound care and reduce avascular necrosis risk in open subtalar dislocations.
  • Early mobilization and physical therapy are crucial for functional recovery.
  • This case highlights a successful management strategy for a severe foot and ankle injury.