Prospective Study of Clinical Outcome of Closed Subtalar Joint Dislocation, Two Years Follow-Up

Background. Acute traumatic subtalar dislocations often present to the emergency with a wide range of variety with respect to the mechanism of injury, clinical presentation and associated fractures around the foot and ankle. The nature of instability and irreducible primary subtalar dislocation, makes their management, challenging. Methods. Here we present five consecutive male patients with the mean age of 24 years (18-35 years). Four patients presented with medial subtalar dislocation and one patient had lateral subtalar dislocation. All the patients except one, had fractures around the foot and ankle. The fracture dislocations in this study were closed type. Results. Two patients underwent closed reduction under sedation in emergency and three had to undergo open reduction in operating room under the appropriate anes-thesia as an emergency procedure. The mean follow-up period was two years. The mean American Orthopaedic Foot and Ankle Society (AOFAS) score was 82.4 out of 100 (ranging from 82 to 97). It was observed that the patients who undergone open reduction, had lower AOFAS score in comparison to the stable closed reduction. Two patients had radiological evidence of subtalar arthritis in the open reduction group, but they were clinically asymptomatic in the latest follow up. Conclusions. Closed subtalar joint dislocation, managed with early closed reduction showed better prognosis in comparison to patients, who presented late and underwent open reduction. However, the overall functional outcome depends on the other associated fractures of the bones of the foot and its complexity. The limitations of our study include the small number of patients and a shorter follow-up time of two years.