Calcaneal fractures
Maneesh Bhatia in Essentials of Foot and Ankle Surgery, 2021
The sustentaculum tali is an important support for the medial arch of the foot. Displaced fractures will disrupt the middle facet of the subtalar joint, can lead to hindfoot varus and may cause problems with the excursion of the flexor hallucis longus tendon inferiorly. Anatomic reduction and rigid fixation will help to prevent potential complications. A medial skin incision along the line of the tibialis posterior tendon over the sustentaculum tali will expose the sheath of the underlying tendon. A safe approach through the bed of the sheath will allow for dorsal retraction of the posterior tibial tendon and plantar retraction of the flexor digitorum longus and flexor hallucis longus tendons, protecting the neurovascular bundle inferiorly. This exposes the sustentacular process and the medial wall of the calcaneum allowing for anatomical reduction of the fracture and fixation with screws or with a small plate (8).
Bones and joints
David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings in McMinn’s Concise Human Anatomy, 2017
Which of the following statements is anatomically accurate with regard to the ankle region?The calcaneus, talus and cuboid form the medial longitudinal arch.The upper surface of the calcaneus and sustentaculum tali articulate with the head and lower aspect of the body of head of talus to facilitate inversion and eversion.The upper surface of the calcaneus and sustentaculum tali articulate with the two malleoli to form the joint that facilitates the movements of inversion and eversion.The calcaneus and cuboid and cuneiform bones form the lateral longitudinal arch.The talus and calcaneus both articulate with the two malleoli to form the joint that facilitates inversion and eversion.
MRI and Ultrasound
Harry Griffiths in Musculoskeletal Radiology, 2008
Now we will turn to the coronal slices starting posteriorly. But remember what is axial in the foot is coronal in the ankle and vice versa. The coronal ankle slices show the Achilles tendon posteriorly: Look at its insertion into the calcaneus. The ankle mortise consists of the distal fibula, distal tibial plafond, and medial malleolus with the talus, lying inside like a carpenter’s mortise joint. Look at the talar domes to make sure the patient does not have osteochondritis dissecans. The medial and lateral collateral ligaments of the ankle are complex. Laterally, there are individual fibulotalar and fibulocalcaneal ligaments as well as a generalized ankle retinaculum. Medially, we have the deltoid ligament, which consists of three main parts: The posterior part is oblique and difficult to see on an MRI: The middle part is the classical “deltoid ligament” as we know it with deep and superficial portions. The deep portion goes from the medial malleolus to the medial aspect of the talus, and the superficial portion, which is much the stronger of the two goes to the calcaneus and mainly to the sustentaculum tali. This is by far the strongest medial ligament. The anterior portion of the deltoid ligament is also oblique, running round from the medial malleolus to the anterior aspect of the talus primarily. Continue going through the coronal slices moving anteriorly. Remember that navicular stress fractures are nearly all in the sagittal plane and thus not easy to see on the sagittal views.
Rasch analysis of the Lower Extremity Functional Scale for foot and ankle patients
Published in Disability and Rehabilitation, 2019
Jussi P. Repo, Erkki J. Tukiainen, Risto P. Roine, Mika Sampo, Henrik Sandelin, Arja H. Häkkinen
Altogether 182 participants who completed the LEFS were included in this analysis. Patient sociodemographic and clinical details are presented in Table 1. Participants had undergone operation due to trauma (n = 176), infection (n = 6), tumor resection (n = 2), or joint destruction because of talocrural arthrosis (n = 1). Fractures were either closed (n = 144) or open (n = 18). The defect was located in the ankle (n = 152), hindfoot (calcaneus, talus; n = 16), midfoot (naviculare, cuboideum, or cuneiforms; n = 9), forefoot (metatarsal bones; n = 5), or was a combination of two or more anatomical regions (n = 5). Comorbidities included diabetes mellitus in 13 patients (7.0%), asthma or chronic obstructive pulmonary disease in nine patients (5.0%), and depression in one patient (0.6%).
Arthroscopic triple arthrodesis for the patient with rheumatoid arthritis; a case report
Published in Modern Rheumatology Case Reports, 2021
Tomoyuki Nakasa, Yasunari Ikuta, Munekazu Kanemitsu, Nobuo Adachi
Once all joints were sufficiently prepared, the subtalar joint was fixed in about 6 degrees valgus heel alignment using a 5.0 mm diameter cannulated cancellous screw (Ace Medical, El Segundo, CA) via a percutaneous stab incision from the calcaneus to the talus. Then, the forefoot was held in a neutral position, and an autologous cancellous bone graft from the iliac crest to the calcaneocuboid joint and talonavicular joint was performed. Bone grafting was performed through the portals in a blind manner. Then, it was confirmed that bone defects were filled with the grafted bone under fluoroscopy. A 5.0 mm diameter cannulated cancellous screw was inserted from the calcaneus bone to the cuboid bone percutaneously. Finally, the talonavicular was fixed using a 4.0 mm diameter cannulated cancellous screw from the navicular to the talus percutaneously (Figure 4(A,B)). After wound closure, a compression dressing and a cast in a neutral alignment were applied. The operation time was 2 h 19 min.
Lateral ankle anatomical variants predisposing to peroneal tendon impingement
Published in Alexandria Journal of Medicine, 2018
Mahmoud Agha, Mohamed Saied Abdelgawad, Nasser Gamal Aldeen
SPR plays an important role in stabilizing the peroneal tendons in the RMG, as a fibrous covering band which extends from the lateral malleolus posteriorly and inferiorly to be inserted at the lateral aspect of the calcaneus. The fibers of the IPR are continuous in front with those of the cruciate crural ligament; behind they are attached to the lateral surface of the calcaneus; some of the fibers are fixed to the peroneal trochlea, forming a septum between the tendons of the Peroneus longus and brevis. Also, the calcaneofibular ligament provides additional stability to the peroneal tendons in the RMG. The OP is a small sesamoid bone located inside the PLT, close to the cuboid. It is seen in 5–26% of the population and is bilateral in 60% of them. Painful os peroneum syndrome (POPS) is a term coined by Sobel et al. which results from a spectrum of conditions, including OP fracture or a diastasis of multipartite OP. These aforementioned OP abnormalities could result in or facilitate PL tendon tear or tenosynovitis, and POPS is frequently missed as a causative factor (Fig. 1).6,7
Related Knowledge Centers
- Abductor Hallucis Muscle
- Achilles Tendon
- Bone
- Navicular Bone
- Tarsus
- Foot
- Heel
- Hock
- Talus Bone
- Abductor Digiti Minimi Muscle of Foot