Ligament Structures in the Tarsal Sinus and Canal

Li, Shuyuan; Hou, Zeng-Guang; Zhang, Peng; Li, Hongliang; Ding, Zhengnian; Liu, Yujie

doi:10.1177/1071100713500653

Cited by 48 publications

(67 citation statements)

References 29 publications

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“…However, inconsistencies occur in morphologies of ITCL. Cadaver studies have shown that there are two distinct ligaments in the tarsal sinus: ITCL and anterior capsular ligament (ACL) [ 7 , 8 ]. It has been suggested that ITCL and ACL should be considered as two distinct ligaments since they have unique insertion and running patterns.…”

Section: Introductionmentioning

confidence: 99%

Subtalar instability: imaging features of subtalar ligaments on 3D isotropic ankle MRI

Kim

Moon

Jung

et al. 2017

BMC Musculoskelet Disord

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BackgroundMRI analysis of subtalar ligaments in the tarsal sinus has not been well performed. We retrospectively investigated the appearance of subtalar ligaments using 3D isotropic MRI and compared imaging findings of subtalar ligaments between patients with subtalar instability (STI) and controls.MethodsPreoperative MRIs of 23 STI patients treated with arthroscopic subtalar reconstruction were compared to MRIs of 23 age- and sex-matched control subjects without STI. Thickness and width of anterior capsular ligament (ACL) and interosseous talocalcaneal ligament (ITCL) as well as thickness of calcaneofibular ligament (CFL) and anterior talofibular ligament (ATFL) were measured. Abnormalities in ACL, ITCL, CFL, ATFL, cervical ligament, and inferior extensor retinaculum were analyzed.ResultsSTI patients had significantly smaller ACL thickness and ACL width than controls (ACL thickness: 1.73 mm vs. 2.22 mm, p = 0.007; ACL width: 7.21 mm vs. 8.80 mm, p = 0.004). ACL thickness of ≤2.1 mm had a sensitivity of 66.7% and a specificity of 66.7% for diagnosis of STI. ACL width of ≤7.9 mm had a sensitivity of 80.0% and a specificity of 76.2% for the diagnosis of STI. However, thickness and width of ITCL, thickness of CFL, or thickness of ATFL was not significantly different between the two groups. Absence or complete tear of ACL was significantly more frequent in STI patients than that in controls (34.8% vs. 8.7%, p = 0.035). Complete tear of CFL and ATFL was more common in STI patients than that in controls, although the difference between the two groups was not statistically significant. Abnormalities of ITCL, cervical ligament, or inferior extensor retinaculum were not significantly different between the two groups.ConclusionsMRI features of thin or narrow ACLs may suggest STI. Absence or complete tear of ACL was significantly more common in STI patients than that in controls.

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Section: Introductionmentioning

confidence: 99%

Subtalar instability: imaging features of subtalar ligaments on 3D isotropic ankle MRI

Kim

Moon

Jung

et al. 2017

BMC Musculoskelet Disord

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“…Tochigi et al suggested that the ITCL restrained the subtalar joint in inversion and prevented anteromedial displacement [30].However, several publications questioned the importance of the ITCL [4,6]. For example, Li et al pointed out that the most important ligament of the tarsal sinus was the CL, while the ITCL, although always present, was a thin single-band ligament [31]. Smith and…”

Section: Discussionmentioning

confidence: 99%

“…Its fiber is oriented from the superolateral calcaneal surface to an inferolateral tubercle on the talus neck. Some researchers believed that the CL was more important than the ITCL in stabilizing the subtalar joint [2,3,31]. Earlier studies found that the CL could restrain the inversion and external rotation of the subtalar joint [7,32,33].…”

Section: Discussionmentioning

confidence: 99%

Biomechanical comparison of tenodesis reconstruction for subtalar instability: a finite element analysis

Wang

et al. 2020

Preprint

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Background: There are several types of tenodesis reconstruction designed for subtalar instability.However, no comprehensive comparison has been conducted among these procedures in terms of their correcting power so far. The objective of this study is to evaluate the biomechanical behaviors of 5 representative procedures through finite element analysis. Methods: A finite element model was established and validated based on one of our previous studies. The Pisani interosseous talocalcaneal ligament(ITCL) reconstruction, Schon cervical ligament(CL) reconstruction and Choisne calcaneofibular ligament(CFL)reconstruction were compared on a model with the CFL, ITCL and CL sectioned. The Schon triligamentous reconstruction and Mann triligamentous reconstruction were compared on a model with the CFL, ITCL and CL, as well as the anterior talofibular ligament (ATFL) sectioned. The inversion and external/internal rotation were quantified in different ankle positions with rotational moment.Results: For single ligament reconstruction, the Choisne CFL reconstruction provided the greatest degree of correction for subtalar instability, followed by the Schon CL reconstruction and then the Pisani ITCL reconstruction. For triligamentous reconstruction, the Mann procedure outperformed the Schon procedure in alleviating the subtalar instability. Conclusion:The finite element analysis showed that the Choisne CFL reconstruction and Mann triligamentous reconstruction provided the greatest degree of immediate postoperative subtalar stability. However, both procedures could not restore the biomechanical behaviors of the subtalar joint to normal. The long-term efficacy of these procedures warrants further investigation using a substantially larger sample of clinical cases.

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“…Several studies have documented the anatomy of the ligaments in and around the TSC (Smith, 1958;Cahill, 1965;Schmidt, 1978;Jotoku et al, 2006, Li et al, 2013. None of these studies has quantified the location of the insertions of those ligaments.…”

Section: Discussionmentioning

confidence: 99%

“…For example, on lateral radiographs, the sinus 'opens' or 'closes' from supination to pronation, respectively (Maceira and Monteagudo, 2015). The TSC anatomy has been studied macroscopically (Smith, 1958;Schmidt, 1978;Schwarzenbach et al, 1997;Lektrakul et al, 2001;Rab et al, 2001;Jotoku et al, 2006;Li et al, 2013), microscopically (Rein et al, 2013), and by medical imaging, mostly magnetic resonance imaging (MRI) (Klein and Spreitzer, 1993;Lektrakul et al, 2001;Lee et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

The dimensions of the tarsal sinus and canal in different foot positions and its clinical implications

et al. 2017

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This study presents a reference for the dimensions of the tarsal sinus and canal in healthy adults in different foot positions to facilitate understanding of the kinematics of the subtalar joint, the effect of an implant, and other clinical issues. In a 3D CT stress test on 20 subjects, the right foot was forced into a neutral and eight different extreme foot positions while CT scans were obtained. The bones were segmented in the neutral foot position. The kinematics of the bones in the extreme positions were determined relative to the neutral position. The dimensions of the tarsal sinus and canal were calculated by determining the radii of the maximal inscribed spheres at 20 equidistant locations along an axis in 3D surface models of the tali and calcanei in each foot position. The radii were small on the medial side and increased laterally. Medial from the middle, the radii were small and not significantly different among the various foot positions. At the lateral side, the dimensions were affected mainly by eversion or inversion and less by dorsiflexion or plantarflexion. The pattern was reproducible among subjects, but there were between-subject differences. The dimensions are mostly determined by rotation in the frontal plane. A pivot point was found medial from the middle. These data serve as a reference and model for predicting the effect of sinus implants and understanding such clinical problems as sinus tarsi syndrome. Between-subjects differences have to be taken into account. Clin. Anat. 30:1049-1057, 2017. © 2017 Wiley Periodicals, Inc.

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Ligament Structures in the Tarsal Sinus and Canal

Abstract: The anatomical description provided here may provide a more accurate theoretical foundation for clinical subtalar stability restoration.

Cited by 48 publications

References 29 publications

Subtalar instability: imaging features of subtalar ligaments on 3D isotropic ankle MRI

Subtalar instability: imaging features of subtalar ligaments on 3D isotropic ankle MRI

Biomechanical comparison of tenodesis reconstruction for subtalar instability: a finite element analysis

The dimensions of the tarsal sinus and canal in different foot positions and its clinical implications

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