Resumo

CARDOSO, Hugo; COSTA, Portela da  e  MAGNO, Leão. Luxação sub-astragalina. Rev. Port. Ortop. Traum. [online]. 2014, vol.22, n.3, pp.325-333. ISSN 1646-2122.

Sub-talar dislocation represents 1.3% of foot dislocations and 15% of talus dislocations. The X-Ray can be normal if the lesion was distal to the talus. The T.C. was more efficient excluding talus-calcaneum dislocations and detecting associated lesions. A closed reduction is possible in the majority of the cases, the prognosis was good or excellent in 70% of cases. The closed reduction is impossible in 10% maybe because of soft tissue interposition. High level energy lesions have bigger probability to originate: (1) instability, (2) walking pain, (3) talus necrosis, (4) post-traumatic ostheoartrosis. We present the clinical case of a male Caucasian patient with 69 years old, victim of falling from a height in May 2011. The fall resulted in the trauma of the right foot and ankle, he presents swollen of right ankle and in an equinus posture, the skin was tense over the lateral side of the ankle; neither vascular impairment nor sensory loss was evident. Because the pulses could not be palpated, the vascular status was assessed by applying pressure to the nails and observing the capillary refill. Radiographic examination revealed a talus sub-dislocation, no fractures were evident, under general anesthesia was easily reduced. A below-the-knee plaster cast was applied with the ankle in neutral position for 4 weeks. He performs a 2 weeks physiotherapy program. Six weeks after the traumatic event the patient was able to walk with full weight bearing without the need of crutches. Actually has 36 months of "follow-up", the A.O.F.A.S. "Score" was 100, has no symptoms, has normal joint motion of the ankle and sub-talar as compared with the counter lateral side, has no degenerative changes and no signs of avascular necrosis such as sclerosis and collapse. Recovered the prior level of activity.

Palavras-chave : Sub-talar; dislocation; reduction; closed.

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