Subtalar Dislocation

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 5 min read
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Subtalar dislocation is the dislocation of the talonavicular and talocalcaneal joints without any associated fractures. Calcaneus and the rest foot dislocate medially, laterally, posteriorly or anteriorly in relation to the talus. Isolated subtalar dislocations are unusual injuries due to the inherent instability of the talus....

For severe symptoms, danger signs, pregnancy, child illness, or sudden worsening, seek urgent medical care.

বাংলা রোগী নোট এখনো যোগ করা হয়নি। পোস্ট এডিটরে “RX Bangla Patient Mode” বক্স থেকে সহজ বাংলা সারাংশ যোগ করুন।

এই তথ্য শিক্ষা ও সচেতনতার জন্য। এটি ডাক্তারি পরীক্ষা, রোগ নির্ণয় বা প্রেসক্রিপশনের বিকল্প নয়।

Article Summary

Subtalar dislocation is the dislocation of the talonavicular and talocalcaneal joints without any associated fractures. Calcaneus and the rest foot dislocate medially, laterally, posteriorly or anteriorly in relation to the talus. Isolated subtalar dislocations are unusual injuries due to the inherent instability of the talus. Subtalar dislocations are frequently associated with fractures of the malleoli, the talus, the calcaneus or the fifth metatarsal. Four types...

Key Takeaways

  • This article explains Other Names in simple medical language.
  • This article explains Mechanism of Injury in simple medical language.
  • This article explains Causes in simple medical language.
  • This article explains Differential Diagnosis in simple medical language.
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Seek urgent medical care if you notice

These warning signs are general safety guidance. Local emergency numbers and clinical judgment should always come first.

  • Severe symptoms, breathing difficulty, fainting, confusion, or rapidly worsening illness.
  • New weakness, severe pain, high fever, or symptoms after a serious injury.
  • Any symptom that feels urgent, unusual, or unsafe for the patient.
1

Emergency now

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2

See a doctor

Book a professional medical evaluation if symptoms persist, worsen, recur often, affect daily activities, or occur in a high-risk patient.

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Definition

Subtalar dislocation is the dislocation of the talonavicular and talocalcaneal joints without any associated fractures. Calcaneus and the rest foot dislocate medially, laterally, posteriorly or anteriorly in relation to the talus.

Isolated subtalar dislocations are unusual injuries due to the inherent instability of the talus. Subtalar dislocations are frequently associated with fractures of the malleoli, the talus, the calcaneus or the fifth metatarsal. Four types of subtalar dislocation have been described according to the direction of the foot in relation to the talus: medial, lateral posterior and anterior. It has been shown that some of these dislocations may spontaneously reduce.

Other Names

  • Subtalar dislocation
  • Talocalcaneal joint dislocation
  • Talonavicular joint dislocation
  • Total talar dislocation
  • Extrusion of the talus
  • Pan-talar dislocation

Description

  • Luxatio tali totalis
  • This page refers to hindfoot dislocations of the Talocalcaneal Joint and Talonavicular Joint
    • Commonly referred to as a ‘subtalar dislocation’
    • This injury should not be confused with an Ankle Dislocation
  • Subtalar dislocations make up 1-2% of all dislocations (need citation)
  • Represent 1% of all traumatic injuries to the foot
  • Associated with
    • 46-83% of case are open, depending on reference material
    • Up to 44% have fractures (need citation)
Medial subtalar dislocation
  • Definition of subtalar dislocation
    • Disruption of articulation of the Talus to the Calcaneus
    • Simultaneous dislocation of the talocalcaneal and talo-navicular joints
    • Absence of tibio-talar or talar neck associated fractures

Mechanism of Injury

Medial subtalar dislocations result from forced inversion force applied to a plantarflexed foot, during this position the neck of the talus will hing and rotate around the sustentaculum tali as a pivot and this will cause a rupture of the lateral talonavicular joint capsule and ligaments, followed by the subtalar ligaments. Fracture of the posterior process of the talus is common to occur with medial disa locations.

Lateral subtalar dislocations result from forced eversion of a dorsiflexed foot during high-energy trauma, during this position the head of the talus rotates around the anterior process of the calcaneus, this will result in rupture of talonavicular and subtalar ligaments and joint capsules. Partial or complete rupture of the deltoid ligament may be presented with this injury because of the high-energy trauma.

Posterior subtalar dislocations result from forced plantar flexion of the foot.

Anterior subtalar dislocations result from anterior traction to the foot when the leg is in a fixed position. It is rare to find obvious foot deformity with posterior or anterior subtalar dislocations.

Causes

  • High energy
    • Most common
    • Examples include Motor vehicle accident, fall from height
  • Low energy
    • Less common
    • Can occur during sports or twisting injuries of the foot

Direction of dislocation

  • Medial (80–85%)[7]
  • Lateral (15–20%)[8]
    • More likely to have soft tissue, osseous injuries
    • More likely to require open reduction
    • Neurovascular injuries have been identified in up to 70 % of cases[9]
  • Posterior (2.5%)
  • Anterior (1%)
  • Total talar dislocation
    • tri-articular dislocation of talus at the tibiotalar, talonavicular and subtalar joints

Associated Conditions

  • Talus Fracture
  • Distal Fibula Fracture
  • Distal Tibia Fracture
  • Fifth Metatarsal Fracture
  • Calcaneus Fracture
  • Navicular Fracture

Pathoanatomy

  • Subtalar Joint
    • Formed by the talus superiorly, the calcaneus and navicular inferiorly
    • Posterior chamber: Talocalcaneal Joint
    • Anterior chamber: Talocalcanealnavicular Join

diagnosis: Differential diagnosis is a list of possible conditions that may explain symptoms. সহজ বাংলা: একই লক্ষণের সম্ভাব্য রোগের তালিকা।" data-rx-term="differential diagnosis" data-rx-definition="Differential diagnosis is a list of possible conditions that may explain symptoms. সহজ বাংলা: একই লক্ষণের সম্ভাব্য রোগের তালিকা।">Differential Diagnosis

  • Fractures & Dislocations
    • Distal Tibia Fracture
    • Distal Fibular Fracture
    • Talus Fracture
    • Calcaneus Fracture
    • Subtalar Dislocation
    • Ankle Fracture (& Dislocation)
    • Peroneal Subluxation
  • Muscle and Tendon Injuries
    • Peroneal Tendon Injuries
    • Achilles Tendonitis
    • Achilles Tendon Rupture
    • Posterior Tibial Tendon Dysfunction
    • Flexor Hallucis Longus Tendinopathy
  • Ligament Injuries
    • Lateral Ankle Sprain
    • Medial Ankle Sprain
    • Syndesmotic Sprain
    • Chronic Ankle Instability
    • Intersection Syndrome Foot
  • Bursopathies
    • Retrocalcaneal Bursitis
  • Nerve Injuries
    • Peroneal Nerve Injury
    • Tarsal Tunnel Syndrome
  • Arthropathies
    • pain and stiffness. সহজ বাংলা: বয়স/ক্ষয়ের কারণে জয়েন্টের ব্যথা।" data-rx-term="osteoarthritis" data-rx-definition="Osteoarthritis is wear-and-tear joint disease causing pain and stiffness. সহজ বাংলা: বয়স/ক্ষয়ের কারণে জয়েন্টের ব্যথা।">Osteoarthritis of the Ankle
    • Osteochondral Defect Talus
  • Pediatrics
    • Fifth Metatarsal Apophysitis (Iselin’s Disease)
    • Calcaneal Apophysitis (Sever’s Disease)
  • Other
    • Haglunds Deformity
    • Posterior Ankle Impingement Syndrome
    • Sinus Tarsi Syndrome

Diagnosis

  • History
    • Patients should be able to describe their injury pattern
    • Will endorse ankle/ foot pain, swelling, deformity
    • Inability to ambulate
  • Physical Exam
    • Gross deformity of the ankle
    • Soft tissue injury may or may not be present (i.e. open/closed)
    • Locked in supination with medial dislocation, pronation with lateral dislocation
  • Special Tests

Radiographs

  • Standard Radiographs Ankle
    • Also consider Standard Radiographs Calcaneus
  • Medial dislocation
    • Talar head superior to navicular on lateral view
  • Lateral dislocation
    • Talar head is colinear or inferior to navicular on lateral view

CT

  • Should be obtained after reduction
  • Helpful to
    • confirm adequate reduction
    • Exclude associated lesions

MRI

  • Role in subtalar dislocation is not well described
  • May be helpful to evaluate the soft tissues

Classification

  • Description
    • Based on position of foot relative to talus at the time of injury[3]
  • Medial dislocation
    • Foot: plantarflexed and inverted followed by an external rotation to the talus
    • Foot is locked in supination
  • Lateral dislocation
    • Foot: foot is everted on plantarflexed foot at the time of injury
    • The foot is locked in pronation
    • More likely to be open
  • Anterior and Posterior dislocation
    • Foot: pulls the foot in forced plantarflexion or translates it in an anterior direction
  • Total dislocation
    • Complete dislocation of talus from ankle, subtalar, talonavicular joints
    • Usually open

Treatment

Acute

  • Follow ATLS algorithm as needed depending on the mechanism of injury
  • Closed Reduction
    • Should be performed emergently, typically in ED (or OR)
    • Under procedural sedation (or general anesthesia)
    • Keep knee flexed to relax calf muscles
    • Immobilization with Posterior Short Leg Splint with Stirrup or Short Leg Cast with bilvalve
  • Approximately 32% require open reduction (need citation)

Nonoperative

  • Indications
    • Roughly 60-70% of cases
  • Immobilize
    • With Posterior Short Leg Splint with Stirrup or Short Leg Cast with bilvalve
    • Duration is typically 4-6 weeks
  • Non weight bearing (NWB)
    • Some authors recommend complete NWB during the entire period of immobilization
  • Physical Therapy

Operative

  • Indications
    • Instability
    • Associated injuries
    • Irreducible with closed reduction
    • Open dislocations
    • Failure of closed reduction
  • Technique
    • Stabilization with K wires
    • External fixation
Doctor visit helper

Prepare before seeing a doctor

A simple rural-patient checklist to help you explain symptoms clearly, ask better questions, and avoid unsafe self-treatment.

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

  • Write when the problem started and how it changed.
  • Bring old prescriptions, investigation reports, and current medicines.
  • Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
  • Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

  • What is the most likely cause of my symptoms?
  • Which danger signs mean I should go to hospital quickly?
  • Which tests are necessary now, and which can wait?
  • How should I take medicines safely and what side effects should I watch for?
  • When should I come for follow-up?

Tests to discuss

  • Vital signs: temperature, pulse, blood pressure, oxygen saturation
  • Basic physical examination by a clinician
  • CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

  • Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
  • Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
  • Do not delay emergency care when danger signs are present.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Rest, drink safe water, and observe symptoms carefully.
  • Keep a written note of symptoms, duration, temperature, medicines already taken, and allergy history.
  • Seek medical care quickly if symptoms are severe, worsening, or unusual for the patient.

OTC medicine safety

  • For mild pain or fever, ask a registered pharmacist or doctor before using common over-the-counter pain/fever medicines.
  • Do not combine multiple pain medicines without advice, especially if you have kidney disease, liver disease, stomach ulcer, asthma, pregnancy, or take blood thinners.
  • Do not give adult medicines to children unless a qualified clinician advises it.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Severe symptoms, confusion, fainting, breathing difficulty, chest pain, severe dehydration, or sudden weakness need urgent medical care.
Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Doctor / qualified healthcare provider
Tests to discuss with doctor
  • Basic vital signs: temperature, pulse, blood pressure, oxygen level if needed
  • Relevant blood, urine, imaging, or specialist tests only after clinical assessment
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Care roadmap for: Subtalar Dislocation

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

RX Patient Help

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Write your symptom story. A health professional or site editor can review it before any answer is prepared. This box is not for emergency care.

Emergency first: Severe chest pain, breathing trouble, unconsciousness, stroke signs, severe injury, heavy bleeding, or rapidly worsening symptoms need urgent local medical care now.

Frequently Asked Questions

Is this article a replacement for a doctor?

No. It is educational content only. Patients should consult a qualified clinician for diagnosis and treatment.

When should I seek urgent care?

Seek urgent care for severe symptoms, rapidly worsening condition, breathing difficulty, severe pain, neurological changes, or any emergency warning sign.

References

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