The effects of a semi‐rigid ankle brace on a simulated isolated subtalar joint instability

Abstract

Subtalar joint instability is hypothesized to occur after injuries to the calcaneofibular ligament (CFL) in isolation or in combination with the cervical and the talocalcaneal interosseous ligaments. A common treatment for hindfoot instability is the application of an ankle brace. However, the ability of an ankle brace to promote subtalar joint stability is not well established. We assessed the kinematics of the subtalar joint, ankle, and hindfoot in the presence of isolated subtalar instability, investigated the effect of bracing in a CFL deficient foot and with a total rupture of the intrinsic ligaments, and evaluated how maximum inversion range of motion is affected by the position of the ankle in the sagittal plane. Kinematics from nine cadaveric feet were collected with the foot placed in neutral, dorsiflexion, and plantar flexion. Motion was applied with and without a brace on an intact foot and after sequentially sectioning the CFL and the intrinsic ligaments. Isolated CFL sectioning increased ankle joint inversion, while sectioning the CFL and intrinsic ligaments affected subtalar joint stability. The brace limited inversion at the subtalar and ankle joints. Additionally, examining the foot in dorsiflexion reduced ankle and subtalar joint motion. ß

The Ankle-Joint Complex: A Kinesiologic Approach to Lateral Ankle Sprains

“…When the CFL is disrupted, the lateral talocalcaneal ligament, cervical ligament, bifurcate ligament, and ITCL ligaments may be damaged. 100 Therefore, if damage to the CFL is suspected, further damage to the subtalar ligaments often follows and must be evaluated systematically. Concurrent injury to the lateral extrinsic and subtalar intrinsic ligaments results in anterolateral instability of the subtalar joint.…”

Suture Anchor Construct for an Exogenous Ligament Repair for Subtalar Joint Instability-A Novel Technique

“…In an acute inversion ankle injury, the most commonly injured structure is the anterior talofibular ligament (ATFL). Approximately, 80% to 85% of these injuries go onto heal with conservative treatment with rehabilitation [1]. However, 74% of these injuries may develop some degree of chronic joint instability [1,2].…”

“…Approximately, 80% to 85% of these injuries go onto heal with conservative treatment with rehabilitation [1]. However, 74% of these injuries may develop some degree of chronic joint instability [1,2]. Up to 75% to 80% of recurrent injuries may also present with chronic subtalar joint instability [1,2].…”

Can Weightbearing Computed Tomography Scans Be Used to Diagnose Subtalar Joint Instability? A Cadaver Study

“…Hindfoot instability often includes the ankle joint but can also affect the subtalar joint . While ankle joint instability can be diagnosed clinically, an accurate assessment of the subtalar joint remains elusive . To provide an adequate treatment for patients with posttraumatic hindfoot instability, a meaningful assessment of the subtalar joint is desirable …”

“…[2][3][4] While ankle joint instability can be diagnosed clinically, an accurate assessment of the subtalar joint remains elusive. 2,3,5 To provide an adequate treatment for patients with posttraumatic hindfoot instability, a meaningful assessment of the subtalar joint is desirable. 2 Two ligaments are the primary stabilizers of the subtalar joint: the interosseous talo-calcaneal ligament (ITCL) and the calcaneo-fibular ligament (CFL).…”