Lateral Talocalcaneal Instability Following Section of the Calcaneofibular Ligament: A Kinesiologic Study

Kjærsgaard‐Andersen, Per; Wethelund, Jon-Oddvar; Nielsen, Strange

doi:10.1177/107110078700700612

Cited by 83 publications

(57 citation statements)

References 10 publications

(3 reference statements)

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“…found an increase in adduction in the talocalcaneal joint to a maximum of 5° after cutting the calcaneofibular ligament [18]. Smaller increases were found after cutting the ligaments of the sinus and canalis tarsi only [17].…”

Section: Subtalar Jointmentioning

confidence: 94%

“…Damage to both of these ligaments results in an increase of varus tilting of the talus within the ankle mortise [25,27]. The calcaneofibular ligament is rarely injured alone, but with or without a combined lesion of the anterior fibular ligament, rupture of this ligament is reported to result in an increase of motion in the subtalar joint [2,10,16,18,20,26,30,32,33,35]. Increase in talocalcaneal movement is found when a lesion of the calcaneofibular ligament is combined with a lesion of the interosseous talocalcaneal ligament [13].…”

Section: Introductionmentioning

confidence: 97%

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Stress Radiography and Stress Examination of the Talocrural and Subtalar Joint on Helical Computed Tomography

et al. 1997

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The main objective of this study was to compare subtalar inversion stress views using the Brodén view with inversion stress views on helical computed tomography (CT). One of the drawbacks of routine radiography is the imaging of three-dimensional structures in a two-dimensional plane. We investigated whether the use of helical CT would lead to a more objective and clearer measurable method to determine the amount of tilt in the subtalar joint. A group of 15 patients with unilateral chronic instability complaints and clinically suspected subtalar instability was examined. The contralateral asymptomatic foot was used as control. A variable amount of subtalar tilt (range, 4 degrees to 18 degrees) was demonstrated in all cases on stress radiographs, without finding significant difference between the symptomatic and asymptomatic feet. However, contrary to the findings at the talocrural level, subtalar tilt was found in none of the patients using helical CT. Thus, we now doubt that the tilt seen during stress examination using the Brodén view is the true amount of tilt. It may be that the lateral opening, seen on these radiographs, largely results from imaging two planes that have made a translatory and rotary movement relative to each other in an oblique direction. It is concluded that the Brodén stress examination might not be useful for screening patients with subtalar instability. Associated anomalies not visible on the radiographs were detected by helical CT. In four cases, narrowing of the articular cartilage and irregular and hypertrophic bone formation at the middle facet joint of the subtalar joints were found. It is likely that these changes cause disturbance of function of this joint and it is suggested that the subjective complaint of instability with "giving way" is not only caused by hypermobility, but can be caused by other disturbance of normal motion.

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Section: Subtalar Jointmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 97%

Stress Radiography and Stress Examination of the Talocrural and Subtalar Joint on Helical Computed Tomography

et al. 1997

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“…Historically, the CFL was recognized as the primary ligamentous stabilizer to the subtalar joint. 9 However, a large body of evidence now supports the ITCL as the primary stabilizer to the subtalar joint. [10][11][12] Recently, Choisne and colleagues 10 reported the greatest increase in subtalar joint instability with sectioning of the ITCL with the foot dorsiflexed, supinated, and inverted.…”

Section: Anatomy and Biomechanical Analysismentioning

confidence: 98%

Subtalar Instability

Aynardi

Pedowitz

Raikin

2015

Foot and Ankle Clinics

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Subtalar instability is a common clinical entity. Clinicians should have a high index of suspicion of this diagnosis in patients who have been diagnosed with chronic lateral ankle instability but have failed standard management and have continued pain in the sinus tarsi. As with ankle instability, nonoperative management is the initial mainstay of treatment. Operative management includes ligamentous reconstruction of key lateral stabilizers of the subtalar joint. Future research on this subject should be focused at improving diagnosis and recognition of this entity.

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“…Since Rubin and Witten34 for the first time suggested the clinical significance of subtalar instability, this topic has received a considerable amount of attention.5,9,15. [22][23][24]27,42,[44][45][46][47][48][49] Clanton" concludes that subtalar instability must be considered as a cause of symptoms in a patient who sustains an inversion type of injury to the ankle and hindfoot, particularly if other causes of instability have been excluded.…”

Section: Introductionmentioning

confidence: 99%

Stress Radiography of the Talocrural and Subtalar Joints

et al. 1995

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The object of this investigation was to determine a possible subtalar component in a group of 33 patients with chronic ankle instability. A group of 10 subjects without ankle/foot symptoms acted as controls. A standardized radiographic assessment of talar and simultaneous subtalar tilt was made. A hinge device to stress the joints and a specific subtalar stress view (Brodén view) were used under fluoroscopic control. Radiographs were made with the feet: (1) in neutral position, (2) after inversion with moderate force until the point of fair restraint (step 1), and (3) after inverting with more force as far as the conditions would allow (step 2). An increase of talar tilt between step 1 and step 2 was only found in feet that were symptomatic. This suggests that this increase is only possible when lateral ligaments are damaged. Further research is necessary to determine whether this finding can serve as a parameter to discriminate between physiological and abnormal talar tilt. A wide range of subtalar motion was found in both symptomatic and asymptomatic feet. With the present method, practically all subtalar joints showed some loss of congruity and medial shift of the calcaneus in relation to the talus. This could not be correlated with ankle instability at the talocrural joint. The consequence of the use of different subtalar stress methods has so far received little attention and is discussed.

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Lateral Talocalcaneal Instability Following Section of the Calcaneofibular Ligament: A Kinesiologic Study

Cited by 83 publications

References 10 publications

Stress Radiography and Stress Examination of the Talocrural and Subtalar Joint on Helical Computed Tomography

Stress Radiography and Stress Examination of the Talocrural and Subtalar Joint on Helical Computed Tomography

Subtalar Instability

Stress Radiography of the Talocrural and Subtalar Joints

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