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.
- Most commonly occurs in younger males with exposure to high-energy trauma
- Accounts for 1% of all dislocations
- Exposure to high-energy trauma
- Prior dislocation or joint hypermobility
- 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).
- Open versus closed
- Medial versus lateral dislocation (anterior and posterior dislocations are very rare)