Journal of foot and ankle research
Conservative Outcomes of Subtalar Dislocation: A Systematic Review and Meta-Analysis of the Current Literature
By Bakr A, Yusuf Y, Tahoun M and 1 others.
Abstract
Background
Subtalar dislocation is a rare injury accounting for 1%-2% of all dislocations. Although prompt closed reduction is the accepted initial treatment, optimal conservative management protocols remain unclear, and no prior systematic review has synthesised outcomes of purely conservatively managed cases across both medial and lateral dislocations. This review aims to systematically assess the rates of post-traumatic osteoarthritis, functional outcomes, subtalar stiffness, avascular necrosis, and need for subsequent surgery following conservative management of acute isolated subtalar dislocations.
Methods
A systematic review was conducted according to the PRISMA 2020 guidelines. PubMed, Cochrane Library, CINAHL, Web of Science and OVID were searched for studies reporting outcomes of conservatively managed acute isolated subtalar dislocations. Eligible studies included case series and cohort studies reporting radiographic or functional outcomes following closed reduction and immobilisation. Risk of bias was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for case series. Radiographic post-traumatic arthritis rates were pooled using random-effects meta-analysis; functional and other outcomes were synthesised narratively. Given the clinical heterogeneity of the included studies, this review adopted an exploratory descriptive framework.