Subtalar dislocation: Difference between revisions
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*Talar head inferior to navicular on lateral XR | *Talar head inferior to navicular on lateral XR | ||
== | ==Management== | ||
*Closed reduction and short leg NWB cast first-line, with ortho consult | *Closed reduction and short leg NWB cast first-line, with ortho consult | ||
*Reduce with ankle plantarflexed, then hindfoot inversion/eversion | *Reduce with ankle plantarflexed, then hindfoot inversion/eversion | ||
Revision as of 01:29, 10 July 2016
Background
- Usually high-energy trauma
- 80% medial dislocations
- 25% open, with lateral more likely
- Associated with fractures ~50%
Clinical Features
Medial
- Foot displaced to supination
Lateral
- Foot displaced to pronation
Differential Diagnosis
Foot diagnoses
Acute
- Foot and toe fractures
- Subtalar dislocation
- Metatarsophalangeal joint sprain (turf toe)
- Acute arterial ischemia
- Calcaneal bursitis
Subacute/Chronic
- Diabetic foot infection
- Peripheral artery disease
- Plantar fasciitis
- Trench foot
- Ingrown toenail
- Paronychia
- Tinea pedis
- Morton's neuroma
- Diabetic neuropathy
Diagnosis
- Xrays
Medial
- Talar head superior to navicular on lateral XR
Lateral
- Talar head inferior to navicular on lateral XR
Management
- Closed reduction and short leg NWB cast first-line, with ortho consult
- Reduce with ankle plantarflexed, then hindfoot inversion/eversion
- Requires CT after reduction for associated fractures
See Also
References
- Weatherford B. Talar neck fractures. Orthobullets, last updated 12/19/14. http://www.orthobullets.com/trauma/1048/talar-neck-fractures.
- Judd DB, Kim DH. Foot Fractures Frequently Misdiagnosed as Ankle Sprains. Am Fam Physician. 2002 Sep 1;66(5):785-795.