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

Abstract

Background: Subtalar dislocations (simultaneous dislocations of the talocalcaneal and talonavicular joints) without concomitant fracture are rare and account for 1-2% of all dislocations. The treatment has been described in several case reports and consists primarily of closed reduction with the patient under anesthesia followed by immobilization.

Case: A 30-year-old male patient sustained a multidimensional nonfractured dislocation of the ankle joint with a predominantly subtalar component (luxatio subtalolateralis) while climbing. As it turned out later, a closed reduction was not possible due to interposition of the tendons of the posterior tibialis muscle and the flexor digitorum pedis longus muscle, so that an open reduction had to be performed. The full extent of the injury could only be assessed during the surgical exploration. The patient was treated in an external fixator for 12 weeks. Subsequently, physiotherapy was initiated. After only 6 months postoperatively the patient showed good mobility, functionality and resilience in the affected ankle joint. After 30 months the patient was free of symptoms. The prolonged immobilization after subtalar dislocation using an external fixator over a total period of 12 weeks, as performed in this case report, demonstrated good long-term functional outcomes.