Fractures and Dislocations of the Talus and Calcaneus: A Case-Based Approach

Peritalar fracture dislocations are relatively uncommon. They usually occur as a result of high-energy trauma and are frequently associated with concomitant bony injuries. If not treated appropriately, these injuries can lead to significant morbidity. Appropriate management includes a meticulous physical examination focused on the condition of the skin and soft tissues, and a thorough understanding of fracture morphology utilizing plain X-ray and computed tomography. Dislocations must be diagnosed and reduced promptly. If closed reduction is unsuccessful, then open reduction is indicated. Peritalar fractures, especially those involving the subtalar joint, can cause residual instability and lead to post-traumatic arthrosis if not accurately reduced. Common complications following subtalar fracture dislocations include hindfoot stiffness, subtalar and/or tibiotalar arthrosis, and soft tissue injuries. Accurate diagnosis, expeditious reduction, and anatomic fixation are essential tenets to lessen long-term sequelae in the management of these complex fracture patterns.