Unusual Subtalar Dislocation with Sustentaculum Tali Fracture: A Case Report

Fractures of the sustentaculum tali are rare injuries that pose significant surgical and rehabilitative challenges, particularly when associated with subtalar dislocation. We present a case of a 45-year-old male who sustained a unique injury of the right heel due to an unusual mechanism, his foot became trapped between the brake and clutch while attempting to drive his car on sand. This resulted in talocalcaneal joint disruption with anterolateral dislocations. This case explains the importance of understanding the applied anatomy, biomechanics, and appropriate management strategies for such unusual complex injuries. Initial X-rays showed the fracture, but a computed tomography (CT) scan was needed for better understanding of the fracture and preoperative planning. Closed reduction of the joint followed by temporary external fixation to stabilize the foot was done in the first stage. Once the soft tissues settled, definitive fixation using a medial approach was done. The patient began early movement exercises and gradually returned to weight-bearing over several weeks. At 6 months, fracture union was achieved with a satisfactory outcome. The patient reported no pain, walked normally, and had no complications like arthritis or stiffness at 3-year follow-up. This case shows how even low-energy twisting injury can cause serious injury in rare locations. A high index of suspicion, quick diagnosis, proper imaging, immediate reduction of the joint, definitive surgery after subsidence of soft tissue swelling, and structured rehabilitation are essential for good outcomes. How to cite this article: Mukhopadhaya J, Bhadani JS. Unusual Subtalar Dislocation with Sustentaculum Tali Fracture: A Case Report. J Foot Ankle Surg (Asia-Pacific) 2025;12(4):211–216.