Case Report
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İzole medial subtalar çıkık: Olgu sunumu ve güncel literatürün gözden geçirilmesi

Year 2020, Volume: 27 Issue: 4, 559 - 563, 25.12.2020
https://doi.org/10.17343/sdutfd.317127

Abstract

Giriş:

Akut subtalar eklem çıkıkları,
talokalkaneal ve talonaviküler eklemlerin eş zamanlı oluşan çıkıkları olup
travmatolojinin nadir vakalarıdır. Genellikle yüksek enerjili travmalar
neticesinde oluşan bu kırıklara yüksek oranda ayak bileğinde yumuşak doku
yaralanması ve kırık eşlik etmektedir. İzole medial subtalar çıkıklar ise çok
nadirdir.

Olgu
sunumu:

Bu vaka sunumu ile 32 yaşında yüksekten
düşme sonucu acil servise başvuran erkek hastayı sunduk. Yapılan fizik muayene
ve radyografik tetkikler neticesinde sol ayak bileğinde izole medial subtalar
çıkık tespit edildi. Acil serviste sedasyon altında kapalı redüksiyon yapılarak
atele alındı ve 24 saat dolaşım takibi sonrası taburcu edildi. Üç hafta sonunda
rehabilitasyona başlandı. 3 haftalık rehabilitasyon sonrası kısmi yük verildi.
Sekiz hafta sonunda tam yüke geçildi. On sekiz ayın sonunda hasta semptomsuz
idi. 

Tartışma:






























Subtalar çıkıklar travmatolojinin acil vakalarıdır.
Medial çıkıklar inversiyondaki ayağın daha instabil olması nedeni ile daha
sıktır.  Redüksiyon mümkün olan en kısa
sürede sağlanmalıdır. Ek kemik ve yumuşak doku patolojilerinin eşlik etmediği,
erken redüksiyonun sağlandığı izole medial subtalar çıkıklarda uzun dönem
fonksiyonel sonuçları mükemmeldir.

References

  • Referans1. Ruhlman F, Paujardieu C, Vernois J, Gayet LE. Isolated acute traumatic subtalar dislocations: Review of 13 cases at a mean follow-up of 6 years and literature review. doi: 10.1053/j.fas.2016.01.044
  • Referans2. Rammelt S, Goronzy J. Subtalar dislocations. Foot Ankle Clin N Am. 2015;20: 253-264.
  • Referans3. Prada-Canizares A, Aunon-Martin I, Rico JV, Pretel- Mazzini J. Subtalar dislocation: management and prognosis for an uncommon orthopaedic condition. International Orthopaedics. 2016;40: 999-1007.
  • Referans4. Camarda L, Abruzzese A, La Gattula A, Lentini R, D’Arienzo M. Results of closed subtalar dislocations. Musculoskeletal Surg. 2016;100: 63-69.
  • Referans5. Hoelscher-Doht S, Frey SP, Kiesel S, Meffert RH, Jansen H. Subtalar dislocation: Long-term follow-up and CT-morphology. Open Journal of Orthopedics. 2015;5: 53-59.
  • Referans6. Azarkane M, Boussakri H, Alayyoubi A, Bachiri M, Elibrahimi A, Elmrini A. Closed medial total subtalar joint dislocation without ankle fracture: a case report. Journal of Medical Case Reports. 2014;8: 313-316.
  • Referans7. Hoexum F, Heetveld MJ. Subtalar dislocation: two cases requiring surgery and a literature of the last 25 years. Arch Orthop Trauma Surg. 2014;134: 1237-1249.
  • Referans8. Kınık H, Oktay O, Arıkan M, Mergen E. Medial subtalar dislocation. International Orthopaedics. 1999;23: 366-367.
  • Referans9. Garofalo R, Moretti B, Ortolano V, Cariola P, Solarino G, Wettstein M, Mouhsine E. Peritalar dislocations: a retrospective study of 18 cases. J Foot Ankle Surg. 2004;43: 166-172.
  • Referans10. Ruiz Valdivieso T, de Miguel Vielba JA, Hernandez Garcia C, Castrillo AV, Alvarez Posadas JI, Sanchez Martin MM. Subtalar dislocation. A study of nineteen cases. Int Orthop. 1996;20: 83-86.
  • Referans11. Merchan EC. Subtalar dislocations: long-term follow-up of 39 cases. Injury.1992;23: 97-100.
  • Referans12. Jungbluth P, Wild M, Hakimi M, Gehrmann S, Djurisic M, Windolf J, Muhr G, Kälicke T. Isolated subtalar dislocations. J Bone Joint Surg Am. 2010;92:890-894.
  • Referans13. Milenkovic S, Mitkovic M, Bumbasirevic M. External fixation of open subtalar dislocations. Injury. 2006;37:909-13.
  • Referans14. De Lee JC, Curtis R. Subtalar dislocation of the foot. J Bone Joint Surg Am. 1982 Mar;64(3):433-7
  • Referans15. Bibbo C, Anderson RB, Davis WH. Injury characteristics and the clinical outcome of subtalar dislocations: a clinical and radiographic analysis of 25 cases. Foot Ankle Int. 2003;24:158-163.
  • Referans16. Xue Y, Zhang H, Pei F, Tu C, Song Y, Fang Y, Liu L. Treatment of displaced talar neck fractures using delayed procedure of plate fixation through dual approaches. Int Orthop. 2014;38:149-154.
  • Referans17. Eisenstein N, Hillier D, Ahmad S. Medial subtalar dislocations with navicular and posterior talar process fracture: the first report in the literatüre. doi: 10.1136/bcr-2012-007763.
  • Referans18. Goldner JL, Poletti SC, Gates HS, Richardson WJ. Severe open subtalar dislocations:long-term results. J Bone Joint Surg Am.1995;77A:1075-1079.

Isolated medial subtalar dislocation: A case report and a review of the current literature

Year 2020, Volume: 27 Issue: 4, 559 - 563, 25.12.2020
https://doi.org/10.17343/sdutfd.317127

Abstract

Introduction:

Acute
subtalar joint dislocations are simultaneous dislocations of talocalcaneal and
talonavicular joints with a rare incidence in traumatology. These fractures
usually occur as a result of high-energy traumas and are accompanied in high numbers
by soft tissue injuries and ankle fractures. However, isolated medial
sub-dislocations are very rare.

Case Presentation:

In this
case report, we present a 32-year-old male patient who applied to the emergency
service after falling from a height. Physical and radiographic examinations
revealed an isolated medial subtalar dislocation in the left ankle. The patient
underwent closed reduction under sedation in the emergency service and was
discharged after 24 hours of follow-up. Three weeks later, rehabilitation was
started. After 3 weeks of rehabilitation, the patient was started with partial
weight bearing and switched to full weight bearing after eight weeks. At the
end of 18 months, the patient did not present with any symptoms.

Discussion:






























Subtalar
dislocations are emergency cases of traumatology. Medial dislocations are more
frequently seen due to the instability caused by the inversion of the foot. Reduction
should be provided as soon as possible. In the treatment of isolated medial
subdural dislocations, immediate reduction offers excellent long-term
functional outcomes particularly in cases that are not accompanied by additional
bone and soft tissue pathologies.

References

  • Referans1. Ruhlman F, Paujardieu C, Vernois J, Gayet LE. Isolated acute traumatic subtalar dislocations: Review of 13 cases at a mean follow-up of 6 years and literature review. doi: 10.1053/j.fas.2016.01.044
  • Referans2. Rammelt S, Goronzy J. Subtalar dislocations. Foot Ankle Clin N Am. 2015;20: 253-264.
  • Referans3. Prada-Canizares A, Aunon-Martin I, Rico JV, Pretel- Mazzini J. Subtalar dislocation: management and prognosis for an uncommon orthopaedic condition. International Orthopaedics. 2016;40: 999-1007.
  • Referans4. Camarda L, Abruzzese A, La Gattula A, Lentini R, D’Arienzo M. Results of closed subtalar dislocations. Musculoskeletal Surg. 2016;100: 63-69.
  • Referans5. Hoelscher-Doht S, Frey SP, Kiesel S, Meffert RH, Jansen H. Subtalar dislocation: Long-term follow-up and CT-morphology. Open Journal of Orthopedics. 2015;5: 53-59.
  • Referans6. Azarkane M, Boussakri H, Alayyoubi A, Bachiri M, Elibrahimi A, Elmrini A. Closed medial total subtalar joint dislocation without ankle fracture: a case report. Journal of Medical Case Reports. 2014;8: 313-316.
  • Referans7. Hoexum F, Heetveld MJ. Subtalar dislocation: two cases requiring surgery and a literature of the last 25 years. Arch Orthop Trauma Surg. 2014;134: 1237-1249.
  • Referans8. Kınık H, Oktay O, Arıkan M, Mergen E. Medial subtalar dislocation. International Orthopaedics. 1999;23: 366-367.
  • Referans9. Garofalo R, Moretti B, Ortolano V, Cariola P, Solarino G, Wettstein M, Mouhsine E. Peritalar dislocations: a retrospective study of 18 cases. J Foot Ankle Surg. 2004;43: 166-172.
  • Referans10. Ruiz Valdivieso T, de Miguel Vielba JA, Hernandez Garcia C, Castrillo AV, Alvarez Posadas JI, Sanchez Martin MM. Subtalar dislocation. A study of nineteen cases. Int Orthop. 1996;20: 83-86.
  • Referans11. Merchan EC. Subtalar dislocations: long-term follow-up of 39 cases. Injury.1992;23: 97-100.
  • Referans12. Jungbluth P, Wild M, Hakimi M, Gehrmann S, Djurisic M, Windolf J, Muhr G, Kälicke T. Isolated subtalar dislocations. J Bone Joint Surg Am. 2010;92:890-894.
  • Referans13. Milenkovic S, Mitkovic M, Bumbasirevic M. External fixation of open subtalar dislocations. Injury. 2006;37:909-13.
  • Referans14. De Lee JC, Curtis R. Subtalar dislocation of the foot. J Bone Joint Surg Am. 1982 Mar;64(3):433-7
  • Referans15. Bibbo C, Anderson RB, Davis WH. Injury characteristics and the clinical outcome of subtalar dislocations: a clinical and radiographic analysis of 25 cases. Foot Ankle Int. 2003;24:158-163.
  • Referans16. Xue Y, Zhang H, Pei F, Tu C, Song Y, Fang Y, Liu L. Treatment of displaced talar neck fractures using delayed procedure of plate fixation through dual approaches. Int Orthop. 2014;38:149-154.
  • Referans17. Eisenstein N, Hillier D, Ahmad S. Medial subtalar dislocations with navicular and posterior talar process fracture: the first report in the literatüre. doi: 10.1136/bcr-2012-007763.
  • Referans18. Goldner JL, Poletti SC, Gates HS, Richardson WJ. Severe open subtalar dislocations:long-term results. J Bone Joint Surg Am.1995;77A:1075-1079.
There are 18 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Case Reports
Authors

Emrah Kovalak

İbrahim Yıldız This is me

Tolga Atay

Salih Korkmaz This is me

Hüseyin Yorgancıgil

Hasan Basri Pınar

Publication Date December 25, 2020
Submission Date May 30, 2017
Acceptance Date August 22, 2017
Published in Issue Year 2020 Volume: 27 Issue: 4

Cite

Vancouver Kovalak E, Yıldız İ, Atay T, Korkmaz S, Yorgancıgil H, Pınar HB. Isolated medial subtalar dislocation: A case report and a review of the current literature. Med J SDU. 2020;27(4):559-63.

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