Evaluation and management of subtalar dislocations.

Twenty subtalar dislocations were reviewed in patients seen at the hospital complex of the University of Pennsylvania, 1950--1979. All patients were available for followup examination and roentgenographic review. These were 15 males and five females in the study. Length of followup ranged from 6 months to 23 years, mean, 4.2 years. Medial dislocation was most frequent, occurring in 17 out of 20. All three with lateral dislocations had associated fractures. All of the dislocations were closed injuries and only one patient required open reduction. Immobilization was maintained in a below-knee weight bearing cast for 6 weeks post-reudction. Of the patients, 80% demonstrated significant restriction of motion and 30% had roentgenographic evidence of arthritis. Few were symptomatic. Fourteen had excellent results, two good, two fair, and two poor. In general, a satisfactory result is to be expected with closed reduction following parenteral medication.