Subtalar Dislocation in an 8-Year-Old Boy: A Rare Clinical Presentation
CPT Jeffrey R. Giuliani, MC; CPT Brett A. Freedman, MC; MAJ Scott B. Shawen, MC; and LTC Gerald L. Farber, MC
Drs. Giuliani, Freedman, Shawen, and Farber are all at the Department of Orthopaedics and Rehabilitation, Walter Reed Army Medical Center, Washington, DC, and Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Abstract not available. Introduction provided instead.
Subtalar dislocation is a rare condition in adults, but it is rare yet in patients less than 18 years old. In the few reports of pediatric subtalar dislocations, both adolescents and young adults have been included in the patient series.1-5 The youngest patient with a true dislocation reported to this point has been a 13-year-old girl. All the previously reported cases were secondary to trauma, and many had associated peritalar or ankle fractures. In the majority of cases reported, the distal tibial and fibular physes would likely have been closed. As a result, hyper-inversion forces were prevented from dissipating through the physis and instead were concentrated at the subtalar joint. In younger patients, the open physes about the ankle are believed to act as the path of least resistance, fracturing prior to subtalar dislocation. At the time of writing, isolated subtalar dislocation had not been described in a patient with documented open peritalar physes. This report describes a case in which an 8-year-old boy with open distal physes sustained an isolated traumatic dislocation.