| Objective: Subtalar dislocation associated with fracture of the posterior process of talus is very rare,We report the diagnose and treatment about this rare case and review related literature to summarize the anatomy of the posterior process,mechanism and treatment of this pattern injury.Methods: A 25-year-old male who suffered an traffic accident was presented with pain,swelling,malformation and activity limitation at the right ankle.X-ray and CT scan revealed subtalar medial dislocation associated with navicular fracture and posterior process fracture of talar.We performed closed reduction and plaster fixation immediately to correct the subtalar dislocation but the result was not satisfied,so the patient underwent open reduction and internal fixation 27 days later after the accident.Result: 8 cases of subtalar dislocation associated with fracture of the posterior process of talus,including 1 case in this paper and 7 cases reported,7 males and 1 females,age ranges from 17 to 52,7 cases under went open reduction and internal fixation and 1 case was treated by minimally invasive technique.The X-ray and CT scan revealed a good reduction after open reduction and internal fixation.There was no pain at the hindfoot and the patient regained a good activity 3 month later after the surgery.Conclusions: When at the time of the impact the foot is in inversion and plantarflexion medial subtalar dislocations occur.The avulsion force from talocalcaneal ligament lead to fracture of posterior process of talus.Subtalar dislocation associated with nodisplaced fracture can be treated conservatively,open reduction and internal fixation is recommended to the case that with fracture displaced more than 2 mm.The symptomatic delayed fractures of posterior process of talus should be excised by arthroscopy.The complications associate with subtalar dislocation include stiffness,arthritis,avascular necrosis andinstability. |
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