Irreducible Subtalar Dislocation Caused by Sustentaculum Tali Incarceration

Area of Science:

• Orthopedic surgery
• Traumatology
• Foot and ankle surgery

Background:

• Subtalar dislocation is a rare injury, particularly the lateral form.
• Surgical intervention is indicated for associated fractures or irreducible dislocations.
• Subtalar arthrosis is a common consequence, even after successful treatment.

Observation:

• A 46-year-old male presented with an irreducible lateral subtalar dislocation.
• Computed tomography (CT) revealed sustentaculum tali incarceration.
• The patient underwent emergent open reduction and internal fixation.

Findings:

• Anatomical reduction and fixation of the sustentaculum tali were achieved with a compression screw.
• At 3-year follow-up, the patient reported an excellent functional outcome with an American Orthopaedic Foot and Ankle Society Ankle-hindfoot score of 86.
• Radiographs showed Grade I subtalar osteoarthritis.

Implications:

• Sustentaculum tali incarceration is an exceptional cause of irreducible subtalar dislocation.
• CT imaging is crucial for accurate fracture assessment and surgical planning.
• Achieving anatomical reduction, stable fixation, adequate immobilization, and diligent rehabilitation are key to optimal functional results in subtalar dislocations.