• Elisa Troiano, Cristina Latino, Alessio Carlisi, Giovanni Battista Colasanti, Nicola Mondanelli, and Stefano Giannotti.
• Department of Medicine Surgery and Neurosciences, University of Siena, Siena, Italy; Section of Orthopedics, Azienda Ospedaliero-Universitaria Senese, Policlinico Santa Maria alle Scotte, Siena, Italy.
• Injury. 2024 Sep 1; 55 Suppl 4: 111474111474.

IntroductionSubtalar dislocation is an uncommon orthopaedic pathology, representing 1 % of all traumatic injuries of the foot and 1-2 % of all dislocations, mostly affecting young male adults. While its urgent treatment consisting in reduction and immobilization of the dislocation has been well described, disagreement exists about post-operative management with specific regards to immobilization length and rehabilitation protocols.Materials And MethodA case series of traumatic subtalar dislocations treated with urgent reduction, a mean of 4 weeks immobilization and subsequent rehabilitation is presented, with 1-year minimum clinical and subjective follow up. Also, a systematic review of the literature concerning the post-operative management following a subtalar dislocation, and subsequent results, has been performed.ResultsAt 1-year minimum follow up, none of the patients presented with complications such as recurrence of dislocation or talus osteonecrosis. Tibio-talar and subtalar range of motion (ROM) were superimposable to the contralateral joints, with a maximum difference of 5°. The American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score highlighted a good functionality and a full recovery in all patients but one. Pure subtalar dislocations led to better results than complicated ones. Review of current literature available on the topic demonstrated that an earlier mobilization resulted in better ROM, but the global outcome did not differ among 4 to 6 weeks of immobilization.DiscussionConflicting reports are present in the literature regarding the most appropriate post-reduction management of subtalar dislocations. In our case series, successful results have been obtained with a mean of 4 weeks of limb immobilization and an early rehabilitation protocol.ConclusionsAlthough some limitations are present, 4 weeks immobilization appears to be the best balance between a good overall outcome and a better recovery of ROM. Further studies are needed to deepen the subject.Copyright © 2024 Elsevier Ltd. All rights reserved.

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