Abstract
Traumatic dislocation of the subtalar joint is an infrequently occurring injury, with
open true posterior dislocation an even rarer injury. We describe our treatment of
a young motorcyclist who was brought into hospital after a road traffic accident,
having sustained an open posterior subtalar dislocation. After initial reduction and
resuscitation in the emergency department, he was taken to the operating theater for
emergent wound debridement and external fixation of his ankle using a unilateral external
fixator device. After 2 subsequent repeat debridements, this was changed to a ring
external fixator device, followed by split-thickness skin grafting of his wound. He
was allowed full weightbearing and was discharged from hospital 10 days after his
last operation. He continued to improve clinically at his outpatient appointments
to the 1-year follow-up point, with his external fixator removed at 6 weeks postoperatively.
At the last follow-up appointment, he had successfully returned to his previous employment.
To the best of our knowledge, only 1 other description of an open posterior dislocation
has been reported, which was managed nonoperatively after wound debridement. Ours
is the first reported case of an open posterior dislocation managed surgically using
a ring external fixator. We believe the ability to allow immediate weightbearing resulting
from the additional stability provided by this type of fixation is advantageous, with
a theoretical reduction in the risk of periarticular osteoporosis and calf muscle
atrophy. The early mobilization afforded by this treatment is hoped to improve the
typically poor long-term outcomes for these patients.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: June 13, 2017
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
© 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.
