Subtalar instability of the foot: A review and results after surgical treatment

Abstract

instability of the foot. A review and results after surgical treatment.Scand J Med Sci Sports 1998: 8: 191-197. 0 Munksgaard, 1998 Most subtalar ligamentous injuries occur in combination with ankle ligament injuries, but the exact aetiology and the true incidence remain unknown. The aim of this study was to review the problem, propose a definition and to analyze the results of an anatomic reconstructive surgical technique in the treatment of subtalar instability. Twenty-two patients suffering from chronic subtalar instability of the foot were operated with anatomical reconstruction. The cervical, the lateral talo-calcaneal and the calcaneo-fibular ligaments were imbricated and reinforced with the lateral root of the inferior extensor retinaculum. After a minimum of 2 years follow-up the functional results were excellent or good in 18 of 22 (82%) patients and fair or poor in 4 of 22 (18%). All of the patients with unsatisfactory results suffered from residual ankle pain, two of whom also had residual instability. No reoperations have been performed. Surgical complications were seen in three patients, all minor nerve injuries of the lateral branch of the superficial peroneal nerve. These complications had no bearing on the functional results, however. This procedure was found to be feasible in patients with chronic subtalar instability.

Influence of kinematic analysis methods on detecting ankle and subtalar joint instability

“…Subtalar joint instability often occurs with lateral chronic ankle instability (Brantigan et al, 1977;Karlsson et al, 1998). Ligaments involved in acute ankle sprains are the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL) (Fujii et al, 2010;Leonard, 1949).…”

“…Subtalar joint instability is frequently associated with ankle injury, in fact 10-25% of patients diagnosed with chronic lateral ankle instability also have instability at the subtalar joint (Brantigan et al, 1977). However, subtalar joint instability is frequently misdiagnosed as ankle instability (Brantigan et al, 1977;Fong et al, 2009;Karlsson et al, 1998;Keefe and Haddad, 2002), thus increasing the risk of long-term complications. Therefore, increased understanding of the mechanics of an unstable subtalar joint may improve the diagnosis and treatment of this joint instability.…”

Effects of lateral ligament sectioning on the stability of the ankle and subtalar joint

“…Most patients have subtalar joint instability for years before treatment because subtalar joint instability is usually inferred after treatment for ankle instability has failed. Subtalar instability was clinically identified to occur with a frequency of 10–25% in patients with chronic lateral functional hindfoot instability,1 and ligaments stabilizing the subtalar joint may be damaged in 50–70% of patients with acute lateral ankle sprains 2. Because the end result of untreated chronic subtalar joint instability is pain, dysfunction, deformity, and potentially degenerative arthritis,3 early diagnosis of this instability is necessary.…”

“…The exact injury mechanism for subtalar joint instability remains unknown 1. It is widely accepted that most subtalar ligamentous injuries occur in combination with injuries of the lateral ligament of the ankle during a severe inversion sprain,1, 13 but it is also believed that subtalar joint instability can occur as an isolated event,3 with inversion of the subtalar joint with the ankle locked in a dorsiflexed position 3, 8. Therefore, various combinations of disrupted ligaments may cause subtalar joint instability.…”

Ankle Stability and Movement Coordination Impairments: Ankle Ligament Sprains

“…These ligaments have a large modulus of elasticity and are considered stabilizers of the subtalar joint throughout the entire range of motion. 136,210 The ligament of Rouvière, or fibulotalocalcaneal ligament, lies distinctly posterior to the calcaneofibular ligament and assists in resisting excessive supination. 122 A combined injury of the anterior talofibular ligament and the interosseous talocalcaneal ligament can induce anterolateral rotatory instability of the ankle joint.…”