Epidemiology
Rare
Types
Medial
- 80%
- calcaneum dislocated medially
Lateral
- 20%
- higher energy injury
Anterior / Posterior
- extremely rare
Pathology
Tearing of strong interosseous ligament
Dislocation of
- talonavicular joint
- talo-calcaneal
Reduction
Conscious sedation
- flex knee to relax gastrocnemius
- increase deformity
- reduce calcaneum whilst holding talus
Blocks to reduction
- medially - talar head buttonholes through capsule / EDB
- laterally - tibialis posterior
Post reduction
CT
- exclude intra-articular fragments
- ensure congruent reduction
Results
Main risk is restricted ROM
- very difficult to treat surgically
- usually stable after reduction
- don't immobilize for long or subtalar joint will stiffen
Risk of osteochondral injury and later OA