True posterior dislocation of subtalar joint: a case report

Posterior dislocation subtalar joint is rare and usually results from a high-velocity injury. Previous reports of all complete posterior dislocations of the subtalar joint have had some degree of a rotational component. We report a case of a true complete posterior dislocation of subtalar joint with no rotation.     

距下关节前脱位合并距骨颈骨折1例

患者李某,男，34岁,农民。2001年8月20日上午11时许，被石块砸伤右踝部，伤后右髁部肿胀疼痛学期工作总结活动受限，0.5h内来院就诊。检查：右小腿下段前侧至踝前皮肤擦伤，右踝部肿胀压痛、畸形，活动受限。足背动脉博动良好，足趾血运及感觉良好。X线侧位片显示距下关节前脱位，足趾颈骨折。正位片显示距舟关节脱位。诊断：距下关节前脱位全并距骨颈骨折。     

Bilateral congenital subtalar dislocation: a case report

Fixed bilateral congenital subtalar dislocations were identified in a 2.5-year-old boy. The patient had been treated previously with a short-leg cast on each foot for 2 months. On presentation the patient ambulated on the medial malleoli and medial aspects of his feet. The patient's activity was limited by pain. At 2.5 years of age, open reduction and pinning of bilateral subtalar joints with soft tissue release and lengthening of the achilles, peroneal, and extensor tendons was done. A thick fibrous band connected the talus and calcaneus laterally. Postoperative treatment included casting for 12 weeks and wearing rigid ankle-foot orthoses which he used for 8 years. There was no recurrence at 10-year followup. The patient has been brace-free for 2 years and is able to ambulate and play school sports without pain. The patient's subtalar range of motion is normal. Radiographic alignment is near normal without degenerative changes. To the authors' knowledge, there has been no previous report of this condition in the literature.     

Irreducible isolated subtalar dislocation: a case report

Subtalar dislocations are uncommon and account for approximately 1% of all dislocations. Optimal management is by immediate closed reduction under general anesthesia. We report 3 cases of irreducible, isolated subtalar dislocation that required an open procedure. Closed reduction failed in 2 patients with lateral dislocation due to interposition of the posterior tibialis tendon caused by a large tear of the flexor retinaculum. The flexor retinaculum was accurately reconstructed after the reduction. In the third case, a medial dislocation, a displaced extensor retinaculum prevented relocation of the talar head and required resection. We also discuss the mechanisms for irreducible subtalar dislocations.     

Irreducible dislocation of the subtalar joint: a report of two cases

Two patients with irreducible lateral dislocation of the subtalar joint are reported. In both patients the injury was closed and associated with a lateral calcaneal fracture. Open reduction confirmed the tendon of tibialis posterior was located around the lateral aspect of the neck of the talus and prevented reduction.     

Treatment of closed subtalar joint dislocation: A case report and literature review

Subtalar dislocation is defined as a separation of the talocalcaneal and talonavicular articulations, commonly caused by high-energy mechanisms, which include falls from height, motor vehicle crashes, and twisting leg injuries. The dislocations are divided into medial, lateral, anterior, and posterior types on the basis of the direction in which the distal part of the foot has shifted in relation to the talus. The mostcommon type is medial dislocation resulted from inversion injury. Subtalar dislocation may accompany with other fractures. Physical examination must be performed carefully to assess for neurovascular compromise. Most of the subtalar dislocations can be treated with closed reduction under sedation. If this is not possible, open reduction without further delay should be conducted. After primary treatment, X-ray and computed tomography scan should be performed to evaluate the alignment and the fractures. We report a 37-year-old male patient sustained a subtalar dislocation without any bony injury when he was playing football. The patient was successfully treated by closed reduction, and a good alignment was observed at the last follow-up. The pathogenesis and treatment method of this case were analyzed, and the related literature were reviewed, which provided a reference for future clinical treatment.     

Anterior subtalar dislocation associated with a fracture of the calcaneus: a case report and review of the literature

A new case of uncommon anterior subtalar dislocation associated with a fracture of the calcaneus is reported. Mechanism of production is described with a review of literature. The criteria of radiologic diagnosis are mentioned. Closed reduction with stabilisation by Kirschner wire were undergone. Prolonged physiotherapy following 6 weeks of immobilisation allowed good result. A decreased subtalar motion without pain was found at the last check up.     

Calcaneal fracture with a concomitant unstable subtalar dislocation: A case report

BackgroundTraumatic 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 reportWe 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.DiscussionThese 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.ConclusionSubtalar 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.     

Anterior dislocation of shoulder in eclampsia: a case report

This case report presents a 25-year-old female patient with anterior dislocation of right shoulder secondary to seizures as a complication of eclampsia.This is an unusual mechanism of injury,but simila...     

Palmar dislocation of the radio-carpal joint: a case report

Radio-carpal joint dislocation, with or without fracture of the radius, is an uncommon injury; only 21 cases have previously been reported. Successful treatments of closed reduction and surgery have also been reported. A 35-year-old right-handed man was injured in a traffic accident and taken to an emergency room of a hospital, where radiographic examination showed a right palmar radio-carpal joint dislocation. Three days after injury, the patient was transferred to our department at Tokyo Medical University, Tokyo. We performed percutaneous pin fixation to maintain the position of his reduced radio-carpal joint. Two years postoperatively, radiographic examination showed a complete union of the avulsion fracture of the radius and a reduction of the joint. He had no marked disturbance in his daily activities apart from a slight pain while working. He had no limitation on the range of motion of the wrist joint and his grip strength was 41.6 kg. He returned to work 3 months after injury.     

Anterior dislocation after total knee arthroplasty: a case report

We report a case of anterior dislocation of an 11-year-old total knee arthroplasty in a 52-year-old woman with severe rheumatoid arthritis and osteoporosis. It was noteworthy that the mechanism of dislocation was unique in that massive wear of ultra-high-molecular-weight polyethylene, avulsion injuries of the medial collateral ligament and patellar tendon, and a stress fracture of the fibula secondary to the increased posterior tilt angle eventually caused anterior dislocation of the left knee without obvious trauma or infection.     

Arthrodesis for chronic lateral subtalar joint dislocation caused by posterior tibial tendon dysfunction: A case report

IntroductionAdult acquired flatfoot deformity (AAFD) caused by posterior tibial tendon dysfunction (PTTD) can lead to the development of peritalar subluxation (PTS) and much more rarely to lateral subtalar dislocation.Presentation of caseA 75-year-old woman was referred to our hospital with an approximately 15-year history of pain in her right foot without obvious trauma. The lateral shifting foot deformity had worsened in the previous 5 years. On presentation, she had tenderness over the talonavicular joint, and the skin overlying the talar head on the medial foot was taut. Imaging revealed lateral displacement of the calcaneus with simultaneous dislocation of the talonavicular and talocalcaneal joints. We diagnosed lateral subtalar dislocation including the talonavicular and talocalcaneal joints caused by PTTD, which we treated by reduction and fusion of the subtalar joint complex. The foot and ankle were immobilized with a cast for 6 weeks.DiscussionAt the 1-year follow-up visit, the patient reported no pain during daily activities, although flatfoot persisted.ConclusionWe report a rare case of chronic lateral subtalar dislocation caused by PTTD that was treated by fusion of the talonavicular and talocalcaneal joints.     

Osteoid osteoma causing subtalar joint arthralgia: A case report

The authors describe a juvenile patient with an osteoid osteoma in the foot-a relatively rare location for this type of lesion. The appearance of this lesion in a juxtaarticular location is even more rare. An 11-year-old boy with a 6-month history of limping secondary to subtalar joint pain presented with a juxtaarticular osteoid osteoma located within the calcaneus. The lesion was present beneath the sinus tarsi and the subtalar joint region. Plain radiographs showed equivocal changes; however, magnetic resonance imaging clearly showed a central nidus. The lateral aspect and midbody of the calcaneus showed a spherical focus of diminished signal on both the T1- and T2-weighted images. This focus had a surrounding rim of significantly diminished signal on all sequences. Thus, findings were most consistent with an osteoid osteoma, although a Brodie abscess could not be ruled out. Surgical excision was performed and led to complete resolution of pain and limping. The pathology report confirmed the diagnosis of osteoid osteoma.     

Anterior elbow dislocation with potential compartment syndrome: a case report

Anterior elbow dislocation is an infrequent lesion, usually produced by direct trauma to the proximal ulna after a fall on the elbow in flexion, and is often associated with soft tissue injuries. The authors report a case of a complex injury produced by a high-energy trauma in the right arm of a 65-year-old patient. His limb was trapped inside an industrial spin-dryer, resulting in a closed anterior elbow dislocation, diaphyseal ulnar shaft, radial styloid process fractures, and an associated compartment syndrome. The injury mechanism and its treatment are described to better manage the soft tissue injury and early elbow mobilization using the FEARM hinged external fixator. A good result was achieved, with almost complete restoration of the patient's arm functions, and he has returned to his previous working activities.     

Traumatic recurrent distal radioulnar joint dislocation: a case report

Isolated acute distal radioulnar joint (DRUJ) dislocation is a rare injury (Garrigues and Aldridge III in J Bone Joint Surg Am 89:1594–1597, 2007]. Reports of isolated DRUJ luxations, volair or dorsal, are often case reports and rarely a series of cases [Dameron Jr in Clin Orthop Relat Res 83:55–63, 1972]. We present a case of an acute traumatic dorsal DRUJ dislocation treated with cast immobilization with recurrence of the dislocation after a new trauma some months later. At follow-up, 17 months after the first dislocation and 9 months after the second, he experienced no pain and had no restrictions in work or sports-related activities.     

距下关节脱位的急诊处理

距下关节脱位(subtak joint dislocation，STJD)主要由高能量的创伤所致，发生率低，仅占全身关节脱位的1％，国内外报告较少。随着工业和交通运输业的飞速发展，STJD的发生率有增加趋势，自1986年1月-2000年12月共收治距下关节脱位36例，急诊处理效果满意，现报告如下。