UMEM Educational Pearls

Title: What's the diagnosis? Case written by Dr. Nadia Eltaki

Posted: 6/11/2012 by Haney Mallemat, MD
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Question

19 year-old male presents with L ankle pain and obvious deformity after jumping out of a window and landing on his inverted foot. What's the diagnosis?

Answer

Sub-talar dislocation

Dislocation of distal talar articulation at talocalcaneal and talonavicular joints (ankle joint is undisturbed)
Also known as "basketball foot"; a common mechanism of injury
Medial dislocation is more common than lateral (85% vs 15%) and it is usually caused by injury while foot is in inversion
Closed reduction is facilitated with knee in flexion to relax the gastrocnemius
Approximately 20% of lateral dislocations require open reduction
CT scan is recommended following closed reduction to rule out osteochondral lesions and better assess the reduction

References

Wheeless' Textbook of Orthopedics

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