Emrah KOVALAK, İbrahim YILDIZ, Tolga ATAY, Salih KORKMAZ, Hüseyin YORGANCIGİL, Hasan Basri PINAR

ISOLATED MEDIAL SUBTALAR DISLOCATION: A CASE REPORT AND A REVIEW OF THE CURRENT LITERATURE

Acute subtalar joint dislocations are simultaneous dislocations of talocalcaneal and talonavicular joints with a rare incidence in traumatology. These fractu res usually occur as a result of high-energy traumas and are accompanied in high numbers by soft tissue injuries and ankle fractures. However, isolated me dial sub-dislocations are very rare considering the fracture- dislocations.In this case report, we present a 32-year-old male patient who applied to the emer gency service after falling from a height. Physical and radiographic examinations revealed an isolated medial subtalar dislocation in the left ankle. The pa tient underwent closed reduction under sedation in the emergency service and was discharged after 24 hours of follow-up. Three weeks later, rehabilitation was started. After 3 weeks of rehabilitation, the patient was started with partial weight bearing and switched to full weight bearing after eight weeks. At the end of 18 months, the patient did not present with any symp toms. Subtalar dislocations are emergency cases of traumatology. Medial dislocations are more frequently seen due to the instability caused by the inversion of the foot. Reduction should be provided as soon as possible. In the treatment of isolated medial subdu ral dislocations, immediate reduction offers excellent long-term functional outcomes particularly in cases that are not accompanied by additional bone and soft tissue pathologies.

İZOLE MEDİAL SUBTALAR ÇIKIK: OLGU SUNUMU VE GÜNCEL LİTERATÜRÜN GÖZDEN GEÇİRİLMESİ

Akut subtalar eklem çıkıkları, talokalkaneal ve talo naviküler eklemlerin eş zamanlı oluşan çıkıkları olup travmatolojinin nadir vakalarıdır. Genellikle yüksek enerjili travmalar neticesinde oluşan bu kırıklara yük sek oranda ayak bileğinde yumuşak doku yaralanma sı ve kırık eşlik etmektedir. İzole medial subtalar çıkık lar ise kırıklı çıkıklara göre çok daha nadirdir. Bu vaka sunumu ile 32 yaşında yüksekten düşme sonucu acil servise başvuran erkek hastayı sunduk. Yapılan fizik muayene ve radyografik tetkikler neticesinde sol ayak bileğinde izole medial subtalar çıkık tespit edildi. Acil serviste sedasyon altında kapalı redüksiyon yapılarak atele alındı ve 24 saat dolaşım takibi sonrası taburcu edildi. Üç hafta sonunda rehabilitasyona başlandı. 3 haftalık rehabilitasyon sonrası kısmi yük verildi. Sekiz hafta sonunda tam yüke geçildi. On sekiz ayın sonun da hasta semptomsuz idi. Subtalar çıkıklar travmato lojinin acil vakalarıdır. Medial çıkıklar inversiyondaki ayağın daha instabil olması nedeni ile lateral çıkık lara nazaran daha sıktır. Redüksiyon mümkün olan en kısa sürede sağlanmalıdır. Ek kemik ve yumuşak doku patolojilerinin eşlik etmediği, erken redüksiyo nun sağlandığı izole medial subtalar çıkıklarda uzun dönem fonksiyonel sonuçları mükemmeldir.

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