Level IV Case Series.

Diagnosis of PMTFF necessitates a heightened clinical suspicion, especially when a medial subtalar joint dislocation is present. Proper imaging studies, such as coronal CT scan, should be performed after any subtalar dislocation. Timely treatment, in the form of open reduction and internal fixation for large fragments involving the articular surface or surgical excision for smaller fragments, is recommended in order to restore proper anatomy and function of the subtalar joint. This study verifies the significant morbidity associated with an undiagnosed or nonoperatively treated PMTFF.

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Objective: To present a serious complication of X-linked hereditary hypophosphatemia. Methods: The authors present the case of a 49-yearold man who presented to the hospital with back pain and was found to have a thoracic myelopathy caused by hypertrophy of the ligamentum flavum. Results: The treating physicians found that the patient had calcification and hypertrophy of the ligamentum flavum that compressed the thoracic spinal cord and caused incomplete paraplegia. The patient's symptoms improved with decompression of the spinal cord. Conclusion: Patients with X-linked hereditary hypophosphatemia are at risk for compression of the spinal cord. Patients with this syndrome who present with back pain need to be examined carefully for evidence of spinal cord compression.