Calcaneal fracture with a concomitant unstable subtalar dislocation: A case report.
Calcaneo-fibular ligament
Subtalar dislocation
Subtalar instability
Synthetic graft
Journal
International journal of surgery case reports
ISSN: 2210-2612
Titre abrégé: Int J Surg Case Rep
Pays: Netherlands
ID NLM: 101529872
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
15
02
2021
revised:
11
03
2021
accepted:
12
03
2021
pubmed:
27
3
2021
medline:
27
3
2021
entrez:
26
3
2021
Statut:
ppublish
Résumé
Traumatic dislocation of the subtalar joint is an infrequently occurring injury, first described by DuFaurest in 1811. They were later on classified by Broca as medial, lateral, posterior and anterior dislocations based on the direction of the dislocation. We present a case of a 30 year old male who presented after a 5 m height fall and direct right foot trauma. Investigations done in the emergency department revealed a right subtalar lateral dislocation with associated calcaneal intraarticular displaced fracture. Open reduction internal fixation of the calcaneal fracture was decided alongside with reduction of the subtalar joint. Intraoperatively the subtalar reduction was totally unstable due to the deficiency of the lateral collateral ligament. A decision of reconstruction of the calcaneofibular ligament using a synthetic ligament was taken. This reconstruction resulted in an adequate intraoperative stability of the subtalar joint. On a 2 year follow up the patient was asymptomatic with no residual subtalar instability. These injuries must be suspected after high energy trauma or twisting forces in the foot. They occur more frequently in men than in women and predominately affect people in their mid-30 s. Our case is unique in that the reconstruction of the calcaneofibular ligament was done using a synthetic graft to stabilize an acute unstable subtalar joint dislocation. Subtalar dislocation is a rare injury with post reduction instability being even rarer. Care has to be taken not to overlook the frequently associated bony injuries, due to their impact on treatment decision and prognosis.
Sections du résumé
BACKGROUND
BACKGROUND
Traumatic dislocation of the subtalar joint is an infrequently occurring injury, first described by DuFaurest in 1811. They were later on classified by Broca as medial, lateral, posterior and anterior dislocations based on the direction of the dislocation.
CASE REPORT
METHODS
We present a case of a 30 year old male who presented after a 5 m height fall and direct right foot trauma. Investigations done in the emergency department revealed a right subtalar lateral dislocation with associated calcaneal intraarticular displaced fracture. Open reduction internal fixation of the calcaneal fracture was decided alongside with reduction of the subtalar joint. Intraoperatively the subtalar reduction was totally unstable due to the deficiency of the lateral collateral ligament. A decision of reconstruction of the calcaneofibular ligament using a synthetic ligament was taken. This reconstruction resulted in an adequate intraoperative stability of the subtalar joint. On a 2 year follow up the patient was asymptomatic with no residual subtalar instability.
DISCUSSION
CONCLUSIONS
These injuries must be suspected after high energy trauma or twisting forces in the foot. They occur more frequently in men than in women and predominately affect people in their mid-30 s. Our case is unique in that the reconstruction of the calcaneofibular ligament was done using a synthetic graft to stabilize an acute unstable subtalar joint dislocation.
CONCLUSION
CONCLUSIONS
Subtalar dislocation is a rare injury with post reduction instability being even rarer. Care has to be taken not to overlook the frequently associated bony injuries, due to their impact on treatment decision and prognosis.
Identifiants
pubmed: 33770637
pii: S2210-2612(21)00279-0
doi: 10.1016/j.ijscr.2021.105778
pmc: PMC8024654
pii:
doi:
Types de publication
Case Reports
Langues
eng
Pagination
105778Informations de copyright
Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.