[Prolonged immobilization with an external fixator for subtalar dislocation without fracture : A case report]

Area of Science:

• Orthopedics
• Traumatology
• Sports Medicine

Background:

• Subtalar dislocations, involving talocalcaneal and talonavicular joints without fracture, are infrequent, comprising 1-2% of all dislocations.
• Standard treatment typically involves closed reduction under anesthesia followed by immobilization.

Purpose of the Study:

• To report a case of multidimensional, nonfractured subtalar dislocation (luxatio subtalolateralis).
• To evaluate the efficacy of open reduction and prolonged external fixation in managing this rare injury.

Main Methods:

• A 30-year-old male sustained a nonfractured subtalar dislocation while climbing.
• Closed reduction failed due to interposition of posterior tibialis and flexor digitorum pedis longus tendons, necessitating open reduction.
• The ankle was immobilized with an external fixator for 12 weeks, followed by physiotherapy.

Main Results:

• Open reduction allowed for full assessment and management of the dislocation.
• The patient demonstrated good ankle joint mobility, functionality, and resilience at 6 months postoperatively.
• Complete symptom resolution was achieved at 30 months postoperatively.

Conclusions:

• Open reduction is a viable option for subtalar dislocations when closed reduction is not feasible.
• Prolonged immobilization (12 weeks) with an external fixator can lead to favorable long-term functional outcomes in subtalar dislocations.
• This case highlights successful management of a rare ankle injury with significant functional recovery.