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Open subtalar dislocation.

I Edmunds¹, D Elliott, S Nade

¹Department of Surgery, Westmead Hospital, New South Wales, Australia.

The Australian and New Zealand Journal of Surgery

|September 1, 1991

Summary

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Open subtalar dislocation is a rare injury with a high incidence of poor outcomes. Infection was the only factor influencing results, suggesting the injury

Area of Science:

Orthopedic surgery
Traumatology
Podiatric medicine

Background:

Open subtalar dislocation is a rare injury, comprising approximately 0.1% of all dislocations.
Limited data exists on the natural history, treatment relevance, and outcomes of this specific injury.
A retrospective review of 10 cases from Westmead Hospital (1978-1988) was conducted.

Observation:

A high incidence (60%) of poor outcomes was observed in the reviewed patient cohort.
Infection emerged as the sole statistically significant factor influencing patient outcomes.
No correlation was found between outcomes and dislocation direction, associated foot fractures, time to reduction, or immobilization duration.

Findings:

The inherent nature of open subtalar dislocation appears to be the primary determinant of poor prognosis.

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Subsequent management strategies, including reduction timing and immobilization, did not significantly impact the outcome.

Infection represents a critical modifiable factor in managing open subtalar dislocations.

Implications:

Future research should focus on infection prevention and management protocols for open subtalar dislocations.
Clinical guidelines may need to be revised to emphasize the intrinsic challenges of this injury.
Understanding the injury's nature is crucial for setting realistic patient expectations and treatment goals.