Diagnosis and treatment of subtalar dislocation of the foot


  • Оleksandr Bodnya




foot, subtalar dislocation, diagnosis, treatment


Subtalar dislocations of the foot are 0.7 % of all traumatic dislocations. Late elimination of foot dislocation leads to avascular necrosis of the talus (16.7 %) and osteoarthritis of the subtalar and talus-heel-scaphoid joints (13.1–47 %). As a result painfull deformation of the foot develops with long lasting disability, which makes patients invalids. Objective: to evaluate clinical data and to find out the reasons of negative results of treatment
of subtalus dislocations. Methods: 17 patients (10 men and 7 women, mean age 37.8 years) were included into the study. There were 15 (88.24 %) internal and 2 (11.76 %) external subtalar dislocations of the foot. In urgency care reduction was done from 2 to 4 hours from the moment of injury in 13 patients, from 5 to 12 hours — in 3, during one day — in 1. Closed subtalar dislocations were eliminated in 10 cases, open — in 7 (3 with open dislocations). American Orthopedic Foot and Ankle Society (AOFAS) scale was used to evaluate functional results. Results: long-term outcomes were studied in 12 (70.6 %) of 17 patients up to 3 years after dislocation. The signs of aseptic necrosis of the talus were not determined on the control radiographs and CT of the foot. The range of motions in the ankle
joint was 64.2° ± 5.1°, in the subtalar joint — it was complete and painless. In majority of cases, the most favorable clinical outcomes were observed in internal dislocations than in external ones. According to the scale AOFAS (91.2 ± 3.5) points were obtained. Positive results of treatment were in 66.67 %, satisfactory — 25 %, unsatisfactory — 8.33 %. Conclusions: adequate elimination of dislocations in the subtalar joint in the early period
after injury allows to preserve the function of the foot, to reduce the period of rehabilitation and to improve the long-term outcomes of treatment. 

Author Biography

Оleksandr Bodnya

Odessa National Medical University. Ukraine

PhD in Traumatology and Orthopaedics


Koryshkov, N. A. (2006). Foot injury. Jaroslavl'-Rybinsk. (in Russian)

DeLee, J. C., Curtis, R. (1982). Subtalar dislocation of the foot. Journal of Bone and Joint Surgery, 64-A (2), 433–437.

Mann, R. A., Baumgarten, M. (1988). Subtalar fusion for isolated subtalar disorders. Preliminary report. Clinical Orthopaedics and Related Research, 226, 260–265.

Jaralov-Jaraljanc, V. A. (1969). Fractures and luxations of foot’s bones. Kiev: Zdorov'ja. (in Ukrainian).

Koryshkov, N. A., Zajcev, O. V. (2003). Features of the treatment of damage to the talus. Vestnik travmatologii i ortopedii im. N. N. Priorova, 1, 46–50. (in Russian).

Liabach, A. P., Ankіn, M. L., & Turchin, A. M. (2011). Operative treatment of closed fractures of talus. Trauma, 2 (12), 68–71. (in Ukrainian).

Naumenko, M. V. (2012). Treatment of patients with fractures, fractures-luxations of os talus: dissertation of the candidate of medical sciences. Moscow. (in Russian).

Telicyn, P. N., & Zhila, N. G. (2015). Surgical treatment of fractures of the talus. Dal'nevostochnyj medicinskij zhurnal, 2, 23–25. (in Russian).

Skorogljadov, A. V., Korobushkin, G. V., Egiazarjan, K. A., & Naumenko, M. V. (2014). X-ray diagnosis of damage to the talus. Moskovskij hirurgicheskij zhurnal, 2 (36), 17–19. (in Russian)

Turchin, A. M., Omel'chenko, T. M., Turchin, O. A., & Homich, S. V. (2013). Modern ideas about the features of anatomy and blood supply to the talus bone (information and analytical review). Lіtopis travmatologіi ta ortopedіi, 1–2 (25–26), 169–172.

Prozorovskij, D. V., Palamarchuk, V. V., Goridova, L. D., & Romanenko, K. K. (2007). Prevention of complication during treatment of talus fractures. Trauma, 3 (8), 312–316. (in Ukrainian)

Skorogljadov, A. V., Naumenko, M. V., Zinchenko, A. V., & Korobushkin, G. V. (2012). Osteochondral lesions of the talus. Bulletin of RSMU, 5, 40–44. (in Russian)

Zegenidze, I. V., Tishkov, N. V. (2013). The therapeutic tactics of intra-articular fractures of the ankle (literature review). The Bulletin of the East-Siberian Scientific Center of the Siberian Branch of the Russian Academy of Medical Sciences, 2 (90), 178–182. (in Russian)

Sokolov, V. A., & Fedosov, A. P. (2006). Subtalus luxations. Expiries of treatment of 11 patients. In: First international conference devoted to surgical treatment of foot and talocrural joint. Moscow. (in Russian)

Kitaoka, H. B., Alexander, I. J., Adelaar, R. S., Nunley, J. A., Myerson, M. S., & Sanders, M. (1994). Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot & Ankle International, 15 (7), 349–353. doi:10.1177/107110079401500701

Skorogljadov, A. V., Korobushkin, G. V., & Naumenko, M. V. (2012). The analysis of outcomes of treatment of talus injuries. Russian Medical Journal, 5, 22–24. (in Russian)