Lateral Subtalar Dislocation with Tarsometatarsal Dislocation: A Case Report of a Rare Injury

Area of Science:

• Orthopedics
• Traumatology
• Podiatry

Background:

• Combined dislocations of the tarsometatarsal and subtalar joints are exceptionally rare.
• Understanding the injury mechanism, optimal treatment, and prognosis for this condition remains limited.

Observation:

• A middle-aged male experienced a rare dislocation of the fourth and fifth tarsometatarsal joints with lateral subtalar dislocation after a trivial twisting fall on ice.
• The patient was otherwise healthy and sustained the injury during a simple slip and fall.

Findings:

• Open reduction and K-wire fixation were required to stabilize the lateral tarsometatarsal and talonavicular joints.
• Postoperatively, the patient achieved a stable, plantigrade foot, enabling a return to his previous occupation.
• One year after surgery, the patient reported mild to moderate pain with prolonged walking, with Foot and Ankle Disability Index and American Orthopaedic Foot and Ankle Society scores of 64 and 65, respectively.
• Radiographic evaluation at one year revealed early signs of post-traumatic arthritis in the midfoot joints.

Implications:

• This case highlights the possibility of severe foot and ankle injuries from low-energy mechanisms.
• Surgical intervention can restore foot stability but does not preclude the development of post-traumatic arthritis.
• Further research is needed to elucidate the specific injury mechanisms and long-term outcomes for these rare dislocations.