Menu Expand
The Subtalar Joint, An issue of Foot and Ankle Clinics of North America, E-Book

The Subtalar Joint, An issue of Foot and Ankle Clinics of North America, E-Book

Norman Espinosa

(2018)

Additional Information

Book Details

Abstract

This issue of Foot and Ankle Clinics, guest edited by Dr. Normal Espinosa, will cover a number of important aspects of the Subtalar Joint in relation to foot and ankle surgery. Topics discussed in this issue include, but are not limited to: Anatomy of the subtalar joint; Biomechanics of the subtalar joint (including normal and pathologic); Open technique for in-situ subtalar fusion; Traumatic injury to the subtalar joint; subtalar instability; and Fractures of the lateral process of talus, among others.

Table of Contents

Section Title Page Action Price
Front Cover Cover
The Subtalar Joint i
Copyright ii
Contributors iii
CONSULTING EDITOR iii
EDITOR iii
AUTHORS iii
Editorial Advisory Board v
Contents vii
Preface: The Subtalar Joint vii
Anatomy of the Subtalar Joint vii
Subtalar Joint Biomechanics: From Normal to Pathologic vii
Traumatic Injury to the Subtalar Joint vii
Fractures of the Lateral Process of the Talus viii
Update on Subtalar Joint Instability viii
Arthroereisis: What Have We Learned? viii
Coalitions of the Tarsal Bones viii
Medial Approach to the Subtalar Joint ix
Open Technique for In Situ Subtalar Fusion ix
Subtalar Arthroscopic Fusion ix
Subtalar Distraction Arthrodesis ix
FOOT AND ANKLE CLINICS x
FORTHCOMING ISSUES x
December 2018 x
March 2019 x
June 2019 x
RECENT ISSUES x
June 2018 x
March 2018 x
December 2017 x
Preface: The Subtalar Joint xi
Anatomy of the Subtalar Joint 315
Key points 315
INTRODUCTION: GENERAL FEATURES 315
TALOCALCANEONAVICULAR JOINT 318
Articular Surfaces 319
Talus 319
Calcaneus 320
Navicular bone 321
Ligaments of the Talocalcaneonavicular Joint 321
CANALIS AND SINUS TARSI 327
Ligamentous System in the Canalis and Sinus Tarsi 329
Vessels and Nerves of the Canalis and Sinus Tarsi 333
TALOCALCANEAL JOINT 333
FUNCTION FOLLOWS FORM: IMPLICATIONS ON SUBTALAR JOINT BIOMECHANICS 335
SUMMARY 336
REFERENCES 336
Subtalar Joint Biomechanics 341
Key points 341
ANATOMY OF THE PERITALAR JOINT 341
AXIS OF THE SUBTALAR/PERITALAR JOINT 343
MIDTARSAL JOINT LOCKING MECHANISM 344
JOINT KINETICS 345
CONTACT CHARACTERISTICS OF THE SUBTALAR JOINT AFTER TRAUMA 346
HINDFOOT VALGUS 347
CAVUS, VARUS, AND DYNAMIC VARUS 348
DYNAMIC VARUS 348
SUMMARY 350
REFERENCES 350
Traumatic Injury to the Subtalar Joint 353
Key points 353
INTRODUCTION 353
SUBTALAR DISLOCATIONS WITH PERIPHERAL TALAR AND CALCANEAL FRACTURES 355
Etiology 355
Diagnosis and Management 355
Early reduction of subtalar dislocations 356
Displaced lateral or posterior talar process fractures 357
Talar head fractures 358
Fractures of the sustentaculum tali 358
Results and Complications 358
CENTRAL TALAR FRACTURES WITH SUBTALAR JOINT INVOLVEMENT 359
Etiology 359
Diagnosis and Management 359
Fractures of the talar neck and body 360
Fractures of the posterior talar body 361
Results and complications 362
CALCANEAL FRACTURES WITH SUBTALAR JOINT INVOLVEMENT 363
Etiology 363
Diagnosis and Management 363
Extensile lateral approach 364
Sinus tarsi approach 365
Fracture-dislocations of the calcaneus 366
Results and Complications 368
REFERENCES 368
Fractures of the Lateral Process of the Talus 375
Key points 375
INTRODUCTION AND EPIDEMIOLOGY 375
MECHANISM OF INJURY 376
CLASSIFICATION 376
Old Classifications 376
Proposal of a Newly Modified Classification 377
ASSOCIATED INJURIES 377
DIAGNOSIS 377
THERAPY 379
SURGICAL TECHNIQUE 380
Timing 380
Position of the Patient 380
Anesthesia 380
Landmarks 380
Approach 381
Reduction 381
Fixation 382
Intraoperative Radiographic Assessment 383
Associated Injuries 383
POSTOPERATIVE CARE 384
Prognosis 384
Complications 384
CASE EXAMPLES 385
Case 1: Lateral Talar Process Fracture Type II 385
Case 2: Lateral Talar Process Fracture Type IIIa 387
Case 3: Lateral Talar Process Fracture Type IIIb 389
Case 4: Lateral Talar Process Fracture Type IIIb (Type IIIc) 392
ACKNOWLEDGMENTS 394
SUPPLEMENTARY DATA 394
REFERENCES 394
Update on Subtalar Joint Instability 397
Key points 397
INTRODUCTION 397
SUBTALAR JOINT ANATOMY AND BIOMECHANICS 398
CLASSIFICATION OF SUBTALAR JOINT INSTABILITY 400
CLINICAL PRESENTATION AND ASSESSMENT 402
History and Clinical Examination 402
Radiographic Examination 403
Three-Dimensional Imaging 404
Subtalar Arthroscopy 404
TREATMENT OF SUBTALAR JOINT INSTABILITY 405
Acute Injury 405
Chronic Subtalar Joint Instability 405
OUTCOME 409
SUMMARY 410
REFERENCES 410
Arthroereisis 415
Key points 415
INTRODUCTION 415
RATIONALE FOR ARTHROEREISIS 416
TYPES OF ARTHROEREISIS 417
BIOMECHANICS 417
INDICATIONS 427
SURGICAL TECHNIQUE 428
REHABILITATION 428
COMPLICATIONS 431
DISCUSSION 432
SUMMARY 432
SUPPLEMENTARY DATA 433
REFERENCES 433
Coalitions of the Tarsal Bones 435
Key points 435
INTRODUCTION 435
HISTORICAL PERSPECTIVE AND INCIDENCE 435
CAUSE 436
PATHOPHYSIOLOGY 437
CLINICAL PRESENTATION 437
IMAGING 438
NATURAL HISTORY 440
CONSERVATIVE TREATMENT 440
SURGICAL RESECTION OF THE COALITION 441
Resection of Calcaneonavicular Coalition 441
Resection of Calcaneonavicular Coalition with Concomitant Flatfoot Reconstruction 442
Calcaneonavicular Coalition and Concomitant Stress Fractures 442
Resection of Talocalcaneal Coalition 442
Resection of a Talocalcaneal Coalition with Concomitant Flatfoot Reconstruction 443
Complications of Resection 443
Postoperative Management 443
JOINT FUSION IN TARSAL COALITION 444
SUMMARY 444
REFERENCES 444
Medial Approach to the Subtalar Joint 451
Key points 451
INTRODUCTION 451
ANATOMY OF MEDIAL APPROACH TO SUBTALAR JOINT 451
OPERATIVE TECHNIQUE FOR OPEN MEDIAL APPROACH TO THE SUBTALAR JOINT 453
ARTHROSCOPIC MEDIAL APPROACH TO THE SUBTALAR JOINT 454
VASCULAR RISKS OF MEDIAL APPROACH TO SUBTALAR JOINT 456
RESULTS OF MEDIAL APPROACH HINDFOOT FUSION 456
SUMMARY 458
REFERENCES 458
Open Technique for In Situ Subtalar Fusion 461
Key points 461
INTRODUCTION 461
PREOPERATIVE ASSESSMENT 462
Anatomic and Biomechanical Aspects 462
Patient History and Clinical Examination 462
Imaging 462
MRI 463
Computed Tomography 463
Diagnostic/Therapeutic Infiltration 464
IN SITU SUBTALAR FUSION—OPERATIVE TECHNIQUE 464
Patient Positioning and Setup 464
Incision 464
Approach 465
Joint Preparation 466
Fixation 468
Wound Closure 469
Postoperative Care 471
SUMMARY 471
REFERENCES 472
Subtalar Arthroscopic Fusion 475
Key points 475
INTRODUCTION 475
BIOMECHANICS 475
EVALUATION 476
INDICATIONS 476
SURGICAL TECHNIQUE 477
RESULTS 481
COMPLICATIONS 482
SUMMARY 482
REFERENCES 482
Subtalar Distraction Arthrodesis 485
Key points 485
INTRODUCTION 485
INDICATIONS 486
CONTRAINDICATIONS 486
PREPARATION OF SURGERY 487
SURGICAL TECHNIQUE IN DETAIL 487
The Authors’ Approach 487
Primary Dissection 488
Intermediate Dissection 489
Deep Dissection 489
Postoperative Regimen 493
PITFALLS AND POTENTIAL COMPLICATIONS 495
RESULTS 496
SUMMARY 497
REFERENCES 497