距骨下関節脱臼の3例

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  • Three Cases of Subtalar Dislocation

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Subtalar dislocation is a rare injury. The incidence has been estimated to be about 1% of all traumatic dislocations. We report 3 cases of subtalar dislocation. Case 1: A 29-year-old man was injured in a traffic accident when driving a car. His right foot was deformed as in club foot. The injury was diagnosed as medial subtalar dislocation according to radiographic appearance. The CT scan finding revealed jamming of navicular and talus head. After unsuccessful manual reduction, open reduction was required. Radiographs at 6 months after the trauma show no avascular necrosis of the talus or arthrosis of subtalar joint, and he is free from complaint. Case 2: A 37-year-old man sustained an open left lateral subtalar dislocation caused by the fall of a heavy machine on his left lower leg. The talus head was exposed and the tibialis posterior tendon and flexor hallucis longus tendon were ruptured. The patient underwent open reduction under lumbar anesthesia. A year later, a radiograph shows no avascular necrosis of the talus or arthrosis of subtalar joint, and now he is free from pain. Case 3: A 21-year-old man suffered subtalar dislocation sustained in a traffic accident while riding a motorcycle. Open reduction was required because the tibialis posterior tendon was jammed into the talonavicular joint. Twenty months after the trauma, arthrosis of the subtalar joint was apparent on radiographs. He feels intermittent ankle pain while jogging. Further investigation and follow-up are necessary in such cases.

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