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SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferences
Emergency: requires immediate attention
Subtalar joint dislocation
Other Resources UpToDate PubMed
Emergency: requires immediate attention

Subtalar joint dislocation

Contributors: Michael Flood, Benedict F. DiGiovanni MD, FAOA, FAAOS
Other Resources UpToDate PubMed

Synopsis

Emergent Care / Stabilization: Assess the patient for additional injuries and for pain control, and order x-rays to evaluate for concomitant fractures. Immediate orthopedic surgery consult is warranted as urgent reduction of the joint is necessary to avoid potential soft tissue or neurovascular compromise.

Causes / typical injury mechanism: Subtalar joint dislocations are relatively rare injuries, typically caused by high-energy traumatic injury. Etiologies can include motor vehicle crashes, sport injuries, and falls from a height.

Classic history and presentation: Patients will present with a recent history of high-energy trauma and pain in the hindfoot, with a visible deformity of the ankle. Medial dislocations are more common than lateral dislocations; it is more frequently a closed injury, but open dislocations do occur given the traumatic nature of the injury.

Prevalence:
  • Most commonly occurs in younger males with exposure to high-energy trauma
  • Accounts for 1% of all dislocations
Risk factors:
  • Exposure to high-energy trauma
  • Prior dislocation or joint hypermobility
Pathophysiology:
  • Medial dislocations are more common than lateral dislocations due to anatomic obstacles. Medial dislocations are associated with lower-energy mechanisms, and with basketball players.
  • Lateral dislocations are higher energy, more often open injuries with, at times, extensive soft tissue damage.
  • Concomitant fractures of talar bones are not uncommon at the talus and calcaneus in particular (periarticular fractures).
Grade / classification system: 
  • Open versus closed
  • Medial versus lateral dislocation (anterior and posterior dislocations are very rare)

Codes

ICD10CM:
S93.316A – Dislocation of tarsal joint of unspecified foot, initial encounter

SNOMEDCT:
281506007 – Dislocation of subtalar joint

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Differential Diagnosis & Pitfalls

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Therapy

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Last Reviewed:10/18/2022
Last Updated:11/08/2022
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Emergency: requires immediate attention
Subtalar joint dislocation
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