Subtalar dislocations: long-term follow-up of 39 cases.

A total of 39 cases of subtalar dislocations, treated during a 10-year period, have been reviewed retrospectively. The average age in this series was 35 years and the average follow-up period was 5.5 years (range 2-10 years); medial dislocations predominated (74 per cent) and a large percentage were open (41 per cent). Associated fractures were frequent (64 per cent). Treatment included closed manipulative reduction but if this was not successful, open reduction was performed followed by Kirschner (K)-wire fixation. Wound cleansing and excision were carried out on the open cases. Results were assessed according to Hardcastle's scoring system and 11 good, 7 fair and 21 poor results were obtained. Associated fractures and open injuries were strongly related to the poor results. Good results were associated with an accurate reduction. Open reduction with K-wire fixation is advocated if minor displacement persists.