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EFORT Open Reviews Nov 2017Subtalar arthroereisis has been reported as a minimally-invasive, effective and low-risk procedure in the treatment of flatfoot mainly in children but also in adults.It... (Review)
Review
Subtalar arthroereisis has been reported as a minimally-invasive, effective and low-risk procedure in the treatment of flatfoot mainly in children but also in adults.It has been described as a standalone or adjunctive procedure, and is indicated in the treatment of flexible flatfoot, tibialis posterior tendon dysfunction, tarsal coalition and accessory navicular syndrome.Different devices for subtalar arthroereisis are currently used throughout the world associated with soft-tissue and bone procedures, depending on the surgeon rather than on standardised or validated protocols.Sinus tarsi pain is the most frequent complication, often requiring removal of the implant.To date, poor-quality evidence is available in the literature (Level IV and V), with only one comparative non-randomised study (Level II) not providing strong recommendations. Long-term outcome and complication rates (especially the onset of osteoarthritis) are still unclear. : 2017;2:438-446. DOI: 10.1302/2058-5241.2.170009.
PubMed: 29218229
DOI: 10.1302/2058-5241.2.170009 -
International Journal of Environmental... Feb 2023This study aimed to clarify the relationship between the joint and ligament structures of the subtalar joint and degeneration of the subtalar articular facet. We...
This study aimed to clarify the relationship between the joint and ligament structures of the subtalar joint and degeneration of the subtalar articular facet. We examined 50 feet from 25 Japanese cadavers. The number of articular facets, joint congruence, and intersecting angles were measured for the joint structure of the subtalar joint, and the footprint areas of the ligament attachments of the cervical ligament, interosseous talocalcaneal ligament (ITCL), and anterior capsular ligament were measured for the ligament structure. Additionally, subtalar joint facets were classified into Degeneration (+) and (-) groups according to degeneration of the talus and calcaneus. No significant relationship was identified between the joint structure of the subtalar joint and degeneration of the subtalar articular facet. In contrast, footprint area of the ITCL was significantly higher in the Degeneration (+) group than in the Degeneration (-) group for the subtalar joint facet. These results suggest that the joint structure of the subtalar joint may not affect degeneration of the subtalar articular facet. Degeneration of the subtalar articular facet may be related to the size of the ITCL.
Topics: Humans; Subtalar Joint; Joint Instability; Ankle Joint; Ligaments, Articular
PubMed: 36833765
DOI: 10.3390/ijerph20043075 -
EFORT Open Reviews Jul 2017Subtalar joint anatomy is complex and can vary significantly between individuals.Movement is affected by several adjacent joints, ligaments and periarticular tendons.The...
Subtalar joint anatomy is complex and can vary significantly between individuals.Movement is affected by several adjacent joints, ligaments and periarticular tendons.The subtalar joint has gained interest from foot and ankle surgeons in recent years, but its importance in hindfoot disorders is still under debate.The purpose of this article is to give a general overview of the anatomy, biomechanics and radiographic assessment of the subtalar joint.The influence of the subtalar joint on the evolution of ankle joint osteoarthritis is additionally discussed. Cite this article: 2017;2:309-316. DOI: 10.1302/2058-5241.2.160050.
PubMed: 28828179
DOI: 10.1302/2058-5241.2.160050 -
Journal of Clinical Orthopaedics and... 2020Calcaneus malunion is a common sequela to calcaneal fractures and is a cause of pain and discomfort. Multiple approaches have been described to address the subtalar... (Review)
Review
Calcaneus malunion is a common sequela to calcaneal fractures and is a cause of pain and discomfort. Multiple approaches have been described to address the subtalar joint and the lateral wall. Type 2 malunion is the most commonly encountered problem, and is usually addressed by the sinus tarsi approach. This has some limitations, as exposure for lateral wall excision beneath the peroneal tendons maybe a problem. We have slightly modified the sinus tarsi approach by a more horizontal skin incision, which may even be extended proximally by 1-2 cm; this allows access to the lateral wall on either side of the peroneal tendons. The approach is described in detail.
PubMed: 32405217
DOI: 10.1016/j.jcot.2020.03.011 -
Orthopaedics & Traumatology, Surgery &... Oct 2013The talonavicular (TN) joint and the three subtalar (ST) joints are linked anatomically and functionally. Together they form the subtalar joint complex, where movement... (Review)
Review
The talonavicular (TN) joint and the three subtalar (ST) joints are linked anatomically and functionally. Together they form the subtalar joint complex, where movement occurs between the calcaneopedal unit (CPU) (entire foot except the talus) and the talotibiofibular unit (talus held tightly by the ankle mortise). Many are unaware of the TN joint's dual membership: it is a component of the subtalar joint complex (talocalcaneonavicular joint) and also the transverse tarsal joint (with the calcaneal-cuboid joint). The anatomy of the articulating surfaces, movement of the CPU when unloaded, shifts and changes in CPU shape with weight bearing, application to clinical tests and X-ray interpretation, and the pathophysiology applications to pes cavovarus, pes planovalgus and congenital talipes equinovarus (club foot) will be reviewed here. The CPU concept corresponds to a horizontal segmentation of the foot. This is a useful supplement to the two other segmentation methods: frontal (hindfoot, midfoot and forefoot) and sagittal (medial and lateral columns). This horizontal segmentation solves the issues with the ST joint complex, which straddles the hindfoot and midfoot, and also the issues with the dual membership of the TN joint. This concept makes it easier to understand foot deformities, better interpret the clinical and radiological signs and deduce logical treatments.
Topics: Calcaneus; Clubfoot; Humans; Orthopedic Procedures; Subtalar Joint
PubMed: 23978710
DOI: 10.1016/j.otsr.2013.07.003 -
Clinical Anatomy (New York, N.Y.) Oct 2020There is a paucity in the literature regarding bilateral symmetry between the facets of the subtalar joint. Often surgeons use the contralateral side as a reference when...
There is a paucity in the literature regarding bilateral symmetry between the facets of the subtalar joint. Often surgeons use the contralateral side as a reference when dealing with a fracture or other joint pathology. Moreover, the presence of osteoarthritic (OA) changes in the subtalar joint is suggested to have a relation with its morphology. In this study, we addressed both these issues. Forty pairs of cadaveric tali and calcanei were analyzed by dissection and measurement. Twenty pairs of asymptomatic calcanei were morphologically analyzed by computer tomography imaging. In the cadaveric feet, the length and width of the facets, the number and interfacet connections, the intersection angle, and the presence of OA changes were registered. In the healthy feet, the orientation and curvature of the posterior facet were analyzed based on cylinder fittings. Bilateral symmetry was tested with paired Student's t tests. Significant associations between morphometric parameters and the presence of OA changes were tested with generalized estimating equation logistic regression models. The morphometric data demonstrated a high degree of bilateral symmetry. The types of tali and calcanei between left and right differed in about one-fifth of the individuals. No significant interactions were found between morphological parameters and the presence of OA changes. Only age had a significant association. There was a high degree of symmetry in the subtalar joints facets. No significant associations were found between OA changes and morphological features, whereas other studies did. Further research is needed to explore this relationship in further detail. Clin. Anat., 33:997-1006, 2020. © 2019 Wiley Periodicals, Inc.
Topics: Adult; Aged; Aged, 80 and over; Cadaver; Dissection; Female; Humans; Male; Middle Aged; Osteoarthritis; Subtalar Joint
PubMed: 31749217
DOI: 10.1002/ca.23525 -
International Journal of Environmental... May 2021Inclination of the subtalar joint (STJ) in the sagittal and transverse planes may be highly associated with ankle pathology. However, the validity and reliability of...
Inclination of the subtalar joint (STJ) in the sagittal and transverse planes may be highly associated with ankle pathology. However, the validity and reliability of measuring the inclination of the STJ axis of rotation (AoR) is not well established. This study aimed to develop a custom-made STJ locator (STJL) and evaluate its reliability and validity. To establish the reliability and validity of the measurement device for STJ AoR, 38 healthy male participants were recruited. For the reliability analysis, test-retest was used, and for validity analysis, Pearson's correlation and Bland-Altman plot analyses were performed. In the reliability analysis of the STJL, a higher correlation was observed with the sagittal plane (0.930) and transverse plane (0.748) (standard error of measurement: 0.56-0.78; minimal detectable difference: 1.57-2.16). In the validity analysis between radiography and STJL, a significantly higher value of 0.798 was obtained with radiography (42.5) and STJL (43.5) with the sagittal plane. The custom-made STJL may be used in the clinical setting as its validity and intraclass correlation coefficient were high, indicating consistent measurements. Further studies including motion analysis are necessary to provide more information regarding the relationship between STJ AoR inclinations and STJ movements.
Topics: Ankle Joint; Humans; Male; Range of Motion, Articular; Reproducibility of Results; Rotation; Subtalar Joint
PubMed: 34065532
DOI: 10.3390/ijerph18105494 -
Orthopaedics & Traumatology, Surgery &... Feb 2019Idiopathic pes planus is common and usually physiologic. Decompensation, when it occurs, may be obvious or on the contrary difficult to identify, raising challenges in... (Review)
Review
Idiopathic pes planus is common and usually physiologic. Decompensation, when it occurs, may be obvious or on the contrary difficult to identify, raising challenges in patient selection for surgical treatment. The physical examination of a child with pes planus must include an evaluation in the supine position, which helps to adjust the amount of correction during surgery. The many reported surgical procedures include repositioning (talus-reseating, subtalar implants and calcaneo-stop screw), osteotomies and joint fusions. The primary treatment goal is to achieve full architectural correction of the deformity. Selection of the procedure depends on patient age and reducibility of the deformity. The joint lines should be preserved whenever possible. Triceps surae contracture should be sought and corrected if found.
Topics: Arthrodesis; Child; Flatfoot; Humans; Joint Prosthesis; Osteotomy; Patient Selection; Physical Examination; Postoperative Care; Preoperative Care; Radiography; Subtalar Joint; Tarsal Bones
PubMed: 29709656
DOI: 10.1016/j.otsr.2018.03.010 -
Journal of Clinical and Diagnostic... Sep 2016Morphological variations of articular facets of calcaneum may predispose people to joint instability, ligamentous laxity and development of arthritic changes in the...
INTRODUCTION
Morphological variations of articular facets of calcaneum may predispose people to joint instability, ligamentous laxity and development of arthritic changes in the subtalar joint. Knowledge of such variations is essential for treatment and diagnostic procedures in orthopaedic surgeries.
AIM
The aim of this study was to determine patterns of articular facets of calcanei and to establish its correlation with calcaneal spurs.
MATERIALS AND METHODS
The study was conducted on 580 adult calcanei of Indian origin at Maulana Azad Medical College and pattern of articular facets were observed and classified according to five patterns described in literature. A digital vernier calliper was used to measure separation between anterior and middle facet. Degree of intersecting angle between anterior and medial facets was calculated using UTHSCSA Image Tool software. The calcaneal spurs were observed by visual inspection.
RESULTS
Out of 580 calcanei, 66.55% had fused anterior and middle facets (Pattern I), 27.59% had all three facets separate (Pattern II), 5.52% had absence of anterior facet (Pattern III), 0.17% had all three facets fused (Pattern IV) and 0.17% had fused middle and posterior facets (Pattern V). A significant side variation was present in Pattern III with predominance on left side. Mean angle of intersection was 147.70 in Pattern I and 133.34 in Pattern II calcaneum. Calcaneal spurs were found in 61.38% out of which it was associated with Pattern I in 43.62%, Pattern II in 14.66% and Pattern III in 2.76%.
CONCLUSION
Individuals with Pattern I and III calcaneum were found to be at a greater risk of subtalar joint instability than individuals with Pattern II. Angle of intersection was obtuse in Pattern I which resulted in ligament laxity and unstable joint. Pattern I was more common in Indian population and this fact necessitates modifications of the western surgical techniques to suit the Indian scenario. An association between the presence of spur and facet configuration was found to be significant.
PubMed: 27790414
DOI: 10.7860/JCDR/2016/20216.8444 -
Frontiers in Bioengineering and... 2023Ankle braces can affect the kinematics of the ankle joint during landing tasks. Previous studies were primarily relied on traditional marker-based motion capture...
Ankle braces can affect the kinematics of the ankle joint during landing tasks. Previous studies were primarily relied on traditional marker-based motion capture systems, which pose limitations in non-invasively capturing the motion of the talus bone. The effect of ankle braces on the kinematics of the tibiotalar and subtalar joints during landing remains unknown. This study used a high-speed dual fluoroscopic imaging system (DFIS) and magnetic resonance imaging (MRI) to investigate effect of ankle braces on the kinematics of the tibiotalar and subtalar joints during landing. Fourteen healthy participants were recruited for this study. During the experiment, static three-dimensional MRI data were collected for each participant, and 3D ankle joint models for the calcaneus, talus, and tibia were constructed. The DFIS was used to capture the images of each participant performing a single-leg landing-jump task at a height of 40 cm. The images were captured once with and without a brace in the fatigue condition, which was induced by running. The six-degree-of-freedom (6DOF) kinematic data were obtained by 2D-3D registration. The flexion-extension range of motion (ROM) (42.73 ± 4.76° vs. 38.74 ± 5.43°, = 0.049) and anterior-posterior translation ROM (16.86 ± 1.74 mm vs. 15.03 ± 1.73 mm, = 0.009) of the tibiotalar joint were decreased. The maximum inversion angle (-3.71 ± 2.25° vs. 2.11 ± 1.83°, = 0.047) of the subtalar joint was decreased. The ankle brace limited the flexion-extension ROM of the tibiotalar joints and the inversion angle of the subtalar joint during landing.
PubMed: 37901843
DOI: 10.3389/fbioe.2023.1255944