Anatomy of the Subtalar Joint

Bartoníček, Jan; Rammelt, Stefan; Naňka, Ondřej

doi:10.1016/j.fcl.2018.04.001

Cited by 49 publications

(33 citation statements)

References 36 publications

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“…Second, the ACaL is often considered as the ITCL [18,19]. Third, footprints are often indicated by schematic figures not based on measurements [18,[20][21][22][23][24].…”

Section: Discussionmentioning

confidence: 99%

The intrinsic subtalar ligaments have a consistent presence, location and morphology

Michels

Matricali

Vereecke

et al. 2021

Foot and Ankle Surgery

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Background: Chronic subtalar instability is a disabling complication after acute ankle sprains. Currently, the literature describing the anatomy of the intrinsic subtalar ligaments is limited and equivocal which causes difficulties in diagnosis and treatment of subtalar instability.The purpose of this study is to assess the anatomical characteristics of the subtalar ligaments and to clarify some points of confusion. Methods: In 16 cadaveric feet, the dimensions and locations of the subtalar ankle ligaments were assessed and measured. CT-scans before dissection and after indication of the footprints with radio-opaque paint allowed to generate 3D models and assess the footprint characteristics. Results: The cervical ligament (CL) had similar dimensions as the lateral ligaments: anterior length 13.9 AE 1.5 mm, posterior length 18.5 AE 2.9 mm, talar width 13.6 AE 2.2 mm, calcaneal width 15.8 AE 3.7 mm. The anterior capsular ligament (ACaL) and interosseous talocalcaneal ligament (ITCL) were found to be smaller structures with consistent dimensions and locations. Conclusion:This study identified consistent characteristics of the intrinsic subtalar ligaments and clarifies the local anatomical situation. The dimensions and footprints of the intrinsic ligaments of the subtalar joint suggest a more important role of the CL and ACaL in the stability of the subtalar joint. The results of this study are relevant to improve diagnostic tools and offer some guidelines when reconstructing the injured ligaments.

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“…Second, the ACaL is often considered as the ITCL [18,19]. Third, footprints are often indicated by schematic figures not based on measurements [18,[20][21][22][23][24].…”

Section: Discussionmentioning

confidence: 99%

The intrinsic subtalar ligaments have a consistent presence, location and morphology

Michels

Matricali

Vereecke

et al. 2021

Foot and Ankle Surgery

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“…The lateral collateral and talocalcaneal ligaments develop from mesenchymal precursors between the 11th and 14th weeks. 3,6 The posterior talofibular ligament is the first to appear in a 33-mm fetus. 4 Any osseous differentiation of the mesenchymal tissue during that period may lead to the formation of ossicles along the ligaments.…”

Section: Discussionmentioning

confidence: 99%

Talus Secundarius: Case Series

2020

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Background: Talus secundarius is a very rare accessory bone at the lateral border of the foot. It is attached via a synchondrosis or small synostosis to the lateral aspect of the talar body and has additional facets to the tip of the lateral malleolus and the superior aspect of the calcaneus. Methods: Over a period of 8 years, we have seen 5 patients with 6 cases of talus secundarius with an average age of 17 years at first presentation to the senior author. One ossicle was an incidental finding and completely asymptomatic. In the other 5 cases, the average duration of symptoms was 21 months at that time. In 3 cases, additional accessory bones were seen around the talus. Results: The average size of the ossicles was 18 × 12 × 8 mm. Complete removal resulted in considerable pain reduction without further functional restriction in 4 cases. Two cases (1 asymptomatic, 1 with mild intermittent symptoms) were treated nonoperatively. The average Foot Function Index improved from 22.6 to 4.8 in all patients and from 31.0 to 4.5 in the patients treated with excision for symptomatic talus secundarius ( P < .01). Conclusion: The knowledge of accessory bones at the foot is important, as missed diagnosis may lead to prolonged course of pain and unnecessary protection in the affected patients. Resection of symptomatic ossicles substantially reduces pain, but patients have to be counseled that some symptoms may prevail in a congenital deformity. Level of Evidence: Level IV, prospective case series.

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“…114 The IER is continuous with the lower leg lateral fascia and is subdivided into 3 layers: (1) the superficial layer inserts into the lateral border of the anterosuperior tubercle of the calcaneus and extends laterally to reinforce the sheath of the peroneal tendons; (2) the intermediate layer forms the pulley for reflection of the extensor digitorum longus and peroneus tertius tendons and inserts into the lateral aspect of the anterior process of the calcaneus; and (3) the deep layer is a part of the central compartment and forms a sling at the neck of the talus, penetrating the canalis tarsi and blending with the ITCL. 9 The IER contributes to the stabilization of the central and lateral compartments; the superficial and intermediate layers of the IER, together with the CL, form the most superficial part of the anterolateral ligamentous support, while the deep layer of the IER connects the structures of the lateral and central compartments. 114 The CL serves as the strongest connection between the talus and calcaneus and inserts in the dorsal surface of the anterior calcaneal tubercle, where it blends with the fibers of the intermediate layer of the IER.…”

Section: Anatomy Of the Subtalar Jointmentioning

confidence: 99%

“…114 The medial ligament complex is composed of the anterior tibiosubtalar section of the deltoid ligament and, in combination with the superomedial aspect of the spring ligament, contributes to keep the subtalar joint stable during sliding, rolling, and torsion. 9 The spring ligament complex (also known as the plantar calcaneonavicular ligament) is a group of ligaments that originate on the anterior calcaneus below and between the anterior and medial facets. 7 The spring ligament plays a key role in supporting and stabilizing the talar head along with the articulating surfaces of the calcaneus and the navicular and assists in stabilizing the anterior subtalar joint.…”

Section: Anatomy Of the Subtalar Jointmentioning

confidence: 99%

Current Concepts on Subtalar Instability

Pereira

Andrade

Espregueira-Mendes

et al. 2021

Orthopaedic Journal of Sports Medicine

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Subtalar instability remains a topic of debate, and its precise cause is still unknown. The mechanism of injury and clinical symptoms of ankle and subtalar instabilities largely overlap, resulting in many cases of isolated or combined subtalar instability that are often misdiagnosed. Neglecting the subtalar instability may lead to failure of conservative or surgical treatment and result in chronic ankle instability. Understanding the accurate anatomy and biomechanics of the subtalar joint, their interplay, and the contributions of the different subtalar soft tissue structures is fundamental to correctly diagnose and manage subtalar instability. An accurate diagnosis is crucial to correctly identify those patients with instability who may require conservative or surgical treatment. Many different nonsurgical and surgical approaches have been proposed to manage combined or isolated subtalar instability, and the clinician should be aware of available treatment options to make an informed decision. In this current concepts narrative review, we provide a comprehensive overview of the current knowledge on the anatomy, biomechanics, clinical and imaging diagnosis, nonsurgical and surgical treatment options, and outcomes after subtalar instability treatment.

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Anatomy of the Subtalar Joint

Cited by 49 publications

References 36 publications

The intrinsic subtalar ligaments have a consistent presence, location and morphology

The intrinsic subtalar ligaments have a consistent presence, location and morphology

Talus Secundarius: Case Series

Current Concepts on Subtalar Instability

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