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Severe open subtalar dislocations. Long-term results

J L Goldner1, S C Poletti, H S Gates

  • 1Division of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina 27710, USA.

The Journal of Bone and Joint Surgery. American Volume
|July 1, 1995
PubMed
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Open subtalar dislocation is a severe foot injury. Long-term outcomes show significant functional deficits and poor anatomical results, impacting patients

Area of Science:

  • Orthopedic Surgery
  • Traumatology
  • Podiatric Medicine

Background:

  • Open subtalar dislocation is a rare and severe foot injury.
  • Long-term sequelae can significantly impact patient function and quality of life.

Purpose of the Study:

  • To evaluate the long-term functional and anatomical outcomes of type-III open subtalar dislocations.
  • To identify associated injuries and their impact on patient recovery.

Main Methods:

  • Retrospective review of fifteen patients with type-III open subtalar dislocation.
  • Average follow-up of eighteen years post-injury.
  • Functional assessment including pain, stair climbing, and ambulation on uneven surfaces.

Main Results:

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  • High incidence of associated injuries: tibial nerve damage (70%), posterior tibial tendon rupture (33%), posterior tibial artery laceration (33%), and fractures (articular, malleolar).
  • Osteonecrosis of the talus occurred in 33% of patients, often requiring triple arthrodesis.
  • Long-term functional deficits: universal ankle pain, difficulty with stairs (60%) and uneven surfaces (93%), with 73% requiring modified footwear.

Conclusions:

  • Open subtalar dislocation results in severe functional impairment and poor anatomical outcomes.
  • Associated injuries significantly complicate recovery and contribute to long-term disability.
  • Arthrodesis can facilitate return to work, but persistent causalgia remains a barrier.