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Subtalar joint

Kun Zhang, Yanxi Chen, Minfei Qiang, Yini Hao
Single, double, and triple hindfoot arthrodeses are used to correct hindfoot deformities and relieve chronic pain. However, joint fusion may lead to dysfunction in adjacent articular surfaces. We compared range of motion in adjacent joints before and after arthrodesis to determine the effects of each procedure on joint motion. The theory of moment of couple, bending moment and balanced loading was applied to each of 16 fresh cadaver feet to induce dorsiflexion, plantarflexion, internal rotation, external rotation, inversion, and eversion...
October 18, 2016: Scientific Reports
Ana Paula Silva, Daniel das Virgens Chagas, Maria Lúcia Cavaliere, Sérgio Pinto, José Silvio de Oliveira Barbosa, Luiz Alberto Batista
OBJECTIVE: To analyse the subtalar eversion range of motion during walking in women with fibromyalgia. METHOD: Twenty women diagnosed with fibromyalgia were directed to walk barefoot at comfortable and self-paced speed on a 7m walkway. Subtalar eversion range of motion was measured using the difference between the maximum and minimum values of subtalar eversion in stance phase. A range of motion between 4°-6° was considered as reference values for subtalar eversion during gait...
September 28, 2016: Foot
Marco Hagen, Gerrit Schwiertz, Karl B Landorf, Hylton B Menz, George S Murley
The pronators and supinators play a key role in the medio-lateral stability of the ankle joint complex (i.e. talo-crural and subtalar joints). We hypothesized that each shank muscle has a specific activation pattern determined by its anatomical course around the axes of the subtalar and talo-crural joints. A secondary objective was to examine the effect of foot posture on these activation patterns. Forty-nine young adults (25 normal-arched feet, 24 flat-arched feet) performed maximum voluntary isometric contractions against manual resistance in four movement directions: plantarflexion (PF), dorsiflexion (DF), pronation (PRO) and supination (SUP)...
October 6, 2016: Human Movement Science
Ewout S Veltman, Ernst Ja Steller, Philippe Wittich, Jort Keizer
A case of complicated lateral subtalar dislocation is presented and the literature concerning this injury is reviewed. Subtalar joint dislocations are rare and often the result of a high-energy trauma. Complications include avascular necrosis of the talus, infection, posttraumatic osteoarthritis requiring arthrodesis and chronic subtalar instability. Negative prognostic factors include lateral and complicated dislocations, total talar extrusions, and associated fractures. A literature search was performed to identify studies describing outcome after lateral subtalar joint dislocation...
September 18, 2016: World Journal of Orthopedics
Peter Van Steyn, Michael Romash
We report a case using retrograde tibial nailing as treatment of nonunion of a distal tibial osteotomy, which was performed as part of a complex reconstruction of distal tibial malunion with ankle arthritis. Although retrograde nailing has classically been used for tibial-talar-calcaneal arthrodesis, this method spares the subtalar joint. Preservation of some hindfoot motion by subtalar mobility allows for a decrease in the loss of function typically seen with tibial-talar-calcaneal arthrodesis.
September 6, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Alexandra I Stavrakis, Nelson F SooHoo
BACKGROUND: This study provides an updated comparison of the reoperation rates following primary ankle arthrodesis and total ankle replacement on the basis of observational, population-based data from California. We previously reported data from 1995 to 2004, and our current study includes new data from 2005 to 2010. Our hypothesis was that total ankle replacement would demonstrate increasing utilization and lower complication rates given advances in implant design and growth in surgeon experience...
September 7, 2016: Journal of Bone and Joint Surgery. American Volume
Tuğba Kuru Çolak, İlker Çolak, Eren Timurtaş, Güven Bulut, M Gülden Polat
Misalignment of the talar neck after surgical repair can redistribute the load among the posterior, middle, and anterior facets of the subtalar joints, which can change the joint biomechanics, cause arthritis, and impair function. However, we found no studies analyzing the plantar pressures after treatment of talus neck fracture. We determined the dynamic plantar pedobarographic and radiographic characteristics and ankle range of motion, function, and pain among patients after surgical repair of talar neck fractures...
September 2, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Isao Matsushita, Hiraku Motomura, Eiko Seki, Tomoatsu Kimura
OBJECTIVES: The long-term effects of tumour necrosis factor (TNF)-blocking therapies on weight-bearing joints in patients with rheumatoid arthritis (RA) have not been fully characterized. The purpose of this study was to assess the radiographic changes of weight-bearing joints in patients with RA during 3-year of TNF-blocking therapies and to identify factors related to the progression of joint damage. METHODS: Changes in clinical variables and radiological findings in 243 weight-bearing joints (63 hips, 54 knees, 71 ankles and 55 subtalar joints) in 38 consecutive patients were investigated during 3 years of treatment with TNF-blocking agents...
September 2, 2016: Modern Rheumatology
Takumi Matsumoto, Richard R Glisson, Markus Reidl, Mark E Easley
BACKGROUND: Joint compression is an essential element of successful arthrodesis. Although subtalar joint compression generated by conventional screws has been quantified in the laboratory, compression obtainable with headless screws that rely on variable thread pitch to achieve bony contact has not been assessed. This study measured subtalar joint compression achieved by 2 posteriorly placed contemporary headless, variable-pitch screws, and quantified additional compression gained by placing a third screw anteriorly...
September 1, 2016: Foot & Ankle International
Albert M Isaacs, Rajiv Midha, Nicholas M Desy, Kimberly K Amrami, Robert J Spinner
Intraneural ganglion cysts in the tarsal tunnel are rare. We present a patient who had an intraneural ganglion cyst involving the medial and lateral plantar and distal tibial nerves. Magnetic resonance imaging revealed evidence to support the joint-related (i.e., subtalar) origin of the cyst. Careful reinterpretation of the imaging supported a phasic mechanism (i.e., cross-over) to explain the interrelated pathogenesis of the intraneural cyst within the three nerves. This mechanism is analogous to that described for the prototypes-the peroneal, tibial and sciatic nerves in the knee region-and can be generalized to other nerves in the foot and ankle region...
November 2016: Acta Neurochirurgica
Nathan Patrick, Gregory S Lewis, Evan P Roush, Allen R Kunselman, Jarrett D Cain
Medial displacement calcaneal osteotomies have been shown to be successful in the surgical management of adult acquired flatfoot, in particular, stage 2 deformity. Classically, the medial displacement calcaneal osteotomy technique has been performed. However, a calcaneal Z osteotomy has been more recently described and applied in the surgical management of flatfoot deformity. Although the potential advantages of the calcaneal Z technique have been reported, data on its effect on the subtalar joint are lacking...
August 18, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Jayishni N Maharaj, Andrew G Cresswell, Glen A Lichtwark
The tibialis posterior (TP) muscle is believed to provide mediolateral stability of the subtalar joint during the stance phase of walking as it actively lengthens to resist pronation at foot contact and then actively shortens later in stance to contribute to supination. Because of its anatomical structure of short muscle fibres and long series elastic tissue, we hypothesised that TP would be a strong candidate for energy storage and return. We investigated the potential elastic function of the TP muscle and tendon through simultaneous measurements of muscle fascicle length (ultrasound), muscle tendon unit length (musculoskeletal modelling) and muscle activation (intramuscular electromyography)...
October 3, 2016: Journal of Biomechanics
Ji-Cheng Gong, Bing-Hua Zhou, Xu Tao, Cheng-Song Yuan, Kang-Lai Tang
BACKGROUND: Tibiotalocalcaneal arthrodesis with headless compression screws has not been previously reported. We hypothesized that these screws could be suitable for tibiotalocalcaneal arthrodesis because of their special design. This study aimed to evaluate the clinical outcomes of patients undergoing tibiotalocalcaneal arthrodesis with headless compression screws for the treatment of severe arthropathy of the ankle and subtalar joint. METHODS: From 2010 to 2015, 23 patients with severe ankle and subtalar arthropathy underwent tibiotalocalcaneal arthrodesis...
2016: Journal of Orthopaedic Surgery and Research
Yvonne R A Kerkhoff, Nienke M Kosse, Wieneke P Metsaars, Jan Willem K Louwerens
BACKGROUND: Total ankle arthroplasty is an accepted alternative to arthrodesis of the ankle. However, complication and failure rates remain high. Long-term results of the Scandinavian Total Ankle Replacement (STAR) are limited, with variable complication and failure rates observed. This prospective study presents the long-term survivorship and postoperative complications of the STAR prosthesis. METHODS: Between May 1999 and June 2008, 134 primary total ankle arthroplasties were performed using the STAR prosthesis in 124 patients...
August 18, 2016: Foot & Ankle International
Richard Walter, Stephen Parsons, Ian Winson
Arthroscopic approaches to subtalar, double, and triple arthrodesis allow relative preservation of the soft tissue envelope compared with traditional open approaches. The surgical technique involving the use of a 4.5-mm 30° arthroscope via sinus tarsi portals is described. All 3 joints of the triple joint can be prepared for fusion with motorized burrs. Rigid fixation is achieved with cannulated screws. High union rates and low complication rates have been reported.
September 2016: Foot and Ankle Clinics
N Vasukutty, V Kumar, M Diab, W Moussa
This is a retrospective review of 80 intra-articular calcaneal fractures treated with open reduction and internal fixation by a specialist team under supervision of a single surgeon in a tertiary centre between 2005 and 2014. The fractures were evaluated with plain radiography and computed tomography, and graded using the Eastwood-Atkins classification. A lateral approach was used and all fractures were fixed with calcaneal plates. All patients had clinical and radiological follow-up. Clinical assessment included foot and ankle disability index, SF-36(®) and Kerr-Atkins scores...
August 11, 2016: Annals of the Royal College of Surgeons of England
S Giannini, M Cadossi, M Mosca, G Tedesco, A Sambri, S Terrando, A Mazzotti
The optimal treatment of calcaneal fractures (CF) is currently controversial and is still under debate. It is well established that conservative treatment of these fractures is associated with poor results. Several surgical techniques are described in the literature; however, there is no consensus on which of these is more effective. The main goals of surgery are to restore the subtalar joint congruence, and calcaneal width, height, shape and alignment, thus avoiding medial and lateral impingement and enabling the patient to resume a normal lifestyle...
August 1, 2016: Injury
Julia Evers, Martin Schulze, Dominic Gehweiler, Martin Lakemeier, Michael J Raschke, Dirk Wähnert, Sabine Ochman
BACKGROUND: Tibiotalocalcaneal arthrodesis (TTCA) using intramedullary nails is a salvage procedure for many diseases in the ankle and subtalar joint. Despite "newly described intramedullary nails" with specific anatomical shapes there still remain major complications regarding this procedure. The following study presents a modified biomechanical test setup for investigations of the hindfoot. METHODS: Nine fresh-frozen specimens from below the human knee were anaysed using the Hindfoot Arthrodesis Nail (Synthes) instrument...
2016: BMC Musculoskeletal Disorders
Koren E Roach, Bibo Wang, Ashley L Kapron, Niccolo M Fiorentino, Charles L Saltzman, K Bo Foreman, Andrew E Anderson
Measurements of joint kinematics are essential to understand the pathomechanics of ankle disease and the effects of treatment. Traditional motion capture techniques do not provide measurements of independent tibiotalar and subtalar joint motion. In this study, high-speed dual fluoroscopy images of ten asymptomatic adults were acquired during treadmill walking at 0.5 m/s and 1.0 m/s and a single-leg, balanced heel-rise. Three-dimensional (3D) CT models of each bone and dual fluoroscopy images were used to quantify in vivo kinematics for the tibiotalar and subtalar joints...
September 1, 2016: Journal of Biomechanical Engineering
Ahmed Fathy Sadek, Mohammed A Laklok, Ezzat H Fouly, Mohamed Elshafie
INTRODUCTION: Infected nonunion of the tibial diaphysis poses one of the most challenging scenarios. There is no clear cut guidelines for cases of infected diaphyseal nonunion with bony defects of ≤6 cm. MATERIALS AND METHODS: A retrospective comparative study was conducted on 30 patients who sustained resistant infected tibial diaphyseal nonunion with bony defect of ≤6 cm. The 30 patients were the sum of two groups; group I (16 patients, mean age 33.6 years) which included all patients, who underwent two stage reconstructions, and Group II patients (14 patients, mean age 29...
September 2016: Archives of Orthopaedic and Trauma Surgery
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