Commonly Missed Peritalar Injuries

Missed Peritalar Injuries

“…Radiographically, a Canale view may increase perceptibility; CT can further assist with diagnosis. 11 Talus fractures and navicular fractures, in our study population, had a negative correlation, indicating that the presence of 1 injury determined the absence of the associated injury. This relationship was the most significant correlation in this study population, with only 1 talus-navicular fracture occurrence (injury also included calcaneal and cuboid fractures; patient 6).…”

“…16 Multiple studies describe LTP fractures initially misdiagnosed as ankle sprains, due to characteristic similarities to an anterior talofibular ligament sprain. 11,[16][17][18][19] McCrory et al reported a 15% rate of misdiagnosis for LTP. 16 recommended ankle mortise views and CT to definitively diagnose this injury and assess intra-articular involvement and comminution.…”

“…16 recommended ankle mortise views and CT to definitively diagnose this injury and assess intra-articular involvement and comminution. 11,18 Posterior talar process (PTP) fractures, which present with tenderness over the posterolateral ankle with pain during forced plantar flexion and flexor halluces longus tendon motion, are commonly misdiagnosed as os trigonum. Kou et al advocated CT scans, versus radiographs, as PTP fractures are difficult to distinguish on plain films, due to adjacent anatomy and possibility of small fragments.…”

“…10 Kou et al defined several commonly missed peritalar injuries and described the radiographic clues to diagnosis to increase awareness in the medical community, discuss each injury, and provide physical examination and imaging methods for successful diagnosis. 11 The definition of peritalar may vary according to anatomic versus kinematic principles. For instance, Ledoux et al described the peritalar joint as the articulations between the talus and calcaneus as well as between the talus and navicular, which then form 2 joint capsules, the subtalar and talocalcaneonavicular joints.…”

“…13 This paper defined the peritalar joint by anatomic structures (ie, talus, navicular, calcaneus, cuboid) and 3 joint capsules (ie, subtalar, calcaneocuboid, talonavicular). 11 Peritalar injuries are defined as fractures or ligamentous disruption resulting in instability of 1 or more peritalar joints. The subtalar joint plays a key role in converting the foot from a mobile structure as it is in heel strike to a rigid structure as it is at toe off.…”