The sinus tarsi syndrome

Abstract

The sinus tarsi syndrome is now a well-defined entity of foot pathology. Usually post-traumatic, it is characterised by pain over the lateral opening of the sinus tarsi and a feeling of instability of the ankle. We were able to define two objective criteria for the syndrome: arthrography of the subtalar joint shows specific abnormalities and recording of the electromyographic function of the peronei demonstrates abnormalities during walking. Conservative treatment is successful in about two-thirds of the cases. In other cases a simple surgical procedure can cure or improve 90% of the patients.

Stability of the Ankle Joint

“…Similar injuries have indeed been produced experimentally by Honigschmied (1877) and Dias (1979). There have also been clinical reports on isolated CFL rupture (Hughes 1942, Berridge and Bonnin 1944, Coltart 1951, Evans 1953, Francillon 1962, Bouretz 1975, Prins 1978, Orlin et al 1980, Solheim et al 1980, Buch et al 1981, Kievernagel 1981, Taillard et al 1981, Tiedtke and Rahmanzadeh 1981. It may seem surprising that the CFL can rupture in isolation, when considering that such a rupture does not give rise to any notable talocrural instability, but it must be borne in mind that the CFL inserts onto the calcaneus and is accordingly also a subtalar ligament.…”

“…There have been reports of ruptures of the ATaFL + CFL (Honigschmied 1977, Hendelberg 1943, isolated rupture or tightening of the CFL (Honigschmied 1877, Cosentino 1956, Robichon et al 1972, Dias 1979, Taillard et al 1981, rupture of the CFL + PTaFL (LaugeHansen 1949, Nevin andPost 1964), or rupture of the ATaFL as well as CFL and PTaFL (Honigschmied 1877, Nevin andPost 1964).…”

Subtalar arthrography in acute injuries of the calcaneofibular ligament

“…19 In our study, the frequencies of leakage of the contrast medium to the peroneal tendon sheaths in combined rupture of the anterior talofibular ligament and the calcaneofibular ligament and in isolated rupture of the anterior talofibular ligament, were significantly different. The absence of the microrecess just along the interosseous ligament, which is seen when this space is filled with blood clot or fibrinous material, 10 was observed more often in patients with ruptured calcaneofibular ligaments than in those without. The presence of the lateral recess just beneath the distal end of the fibula follows a tear of the lateral wall of the capsule of the subtalar joint which usually involves the calcaneofibular ligament.…”

“…A 21-gauge needle 5 cm long was introduced at the posterior facet of the talocalcaneal joint from the posterolateral approach as described by Taillard et al, 10 and water-soluble contrast medium injected. The mean volume sufficient to fill the joint was 2.8 ml (2.0 to 7.0).…”

“…Demonstration of instability of the subtalar joint by stress radiography is not easy, because the force used primarily affects the unstable ankle and true instability of the subtalar joint may be masked. Meyer et al 1,10 undertook subtalar arthrography in patients with acute ankle sprains and noted a high incidence of subtalar injury. They showed its value for the diagnosis of a subtalar sprain, but did not describe the details of the procedure.…”