Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Talus”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,027 records · Page 57Linked to original sources
PubMed1996

Talar neck fractures: anatomic considerations for posterior screw application.

The bony window available for posterior screw placement in the talus and the morphology of the talar neck were studied in 50 dry tali. In addition, 12 cadaver specimens were used to study the posterolateral approach. The bony window was bounded medially by the lateral tubercle of the posterior process of the talus, laterally by the fibular facet, superiorly by the trochlear articular surface, and inferiorly by the posterior calcaneal facet. The average vertical thickness at 2-mm increments was recorded across the talar neck to define the bony mass available for screw insertion. The smallest thickness of the talar neck was at a point 2 mm medial to the lateral border. The thickness progressively increased in a medial direction. The superior talar neck surface was found to have an average width of 18.4 +/- 1.6 mm. The angle formed between the superior and lateral surfaces of the talar neck averaged 29.3 degrees, which would account for the better delineation of the lateral border of the neck under fluoroscopy of the talus with the foot in pronation. The diameter of the screw in relation to the window height should be considered.

Adolescent↗
PubMed2006

Fracture of the os trigonum: a case report.

The os trigonum is an inconsistently present accessory bone of the foot situated at the posterolateral aspect of the talus. It may be radiographically confused with fractures of the posterior process of the talus. Fracture of the os trigonum per se is extremely rare. Hyperplantarflexion of the ankle is the mechanism of injury in which the os trigonum is compressed between the posterior malleolus of the tibia and the tuber calcaneus. Computed tomography is the choice of imaging modality in cases where fractures of posterior talus structures, including the os trigonum, are suspected. A high index of suspicion is necessary to diagnose a fracture of the os trigonum after a severe plantarflexion injury to the ankle. Conservative treatment is usually successful. We report a case of a fracture of the os trigonum, its clinical features, treatment and significance.

Adult↗
PubMed1999

Assessment of hindfoot deformity by three-dimensional MRI in infant club foot.

In 12 infants aged under 16 months with unilateral club foot we used MRI in association with multiplanar reconstruction to calculate the volume and principal axes of inertia of the bone and cartilaginous structures of the hindfoot. The volume of these structures in the club foot is about 20% smaller than that in the normal foot. The reduction in volume of the ossification centre of the talus (40%) is greater than that of the calcaneus (20%). The long axes of both the ossification centre and the cartilaginous anlage of the calcaneus are identical in normal and club feet. The long axis of the osseous nucleus of the talus of normal and club feet is medially rotated relative to the cartilaginous anlage, but the angle is greater in club feet (10 degrees v 14 degrees). The cartilaginous structure of the calcaneus is significantly medially rotated in club feet (15 degrees) relative to the bimalleolar axis. The cartilaginous anlage of the talus is medially rotated in both normal and club feet, but with a smaller angle for club feet (28 degrees v 38 degrees). This objective technique of measurement of the deformity may be of value preoperatively.

Calcaneus↗
PubMed1999

Congenital convex pes valgus.

Congenital convex pes valgus (congenital vertical talus) is a rare condition. We reviewed ten feet in seven patients who had had surgical correction. All had been operated on by the senior author (JF) and the same surgical technique was used throughout, incorporating transfer of the tibialis anterior to the neck of the talus. The mean age at surgery was 31 months and the mean follow-up was nine years (6 to 14). All patients completed a questionnaire and had clinical, radiological and photographic evaluation performed by an independent examiner. None had required further surgery. All but one were satisfied with the result, and had no functional limitations. They all wore normal shoes. The mean ankle dorsiflexion was 17 degrees and plantar flexion 21 degrees. The mean arc of subtalar motion was 27 degrees. All radiological parameters measured were within the normal range, although irregularity of the talonavicular joint was common. No avascular necrosis of the body of the talus was seen. We conclude that the medium-term results of this procedure are very satisfactory.

Age Factors↗
PubMed2005

Process and tubercle fractures of the hindfoot.

Process and tubercle fractures of the talus and calcaneus can be a source of significant pain and dysfunction. Successful management requires extensive knowledge of the complex osseoligamentous anatomy of the hindfoot. The large posterior process of the talus is composed of a medial and a lateral tubercle; an os trigonum may exist posterior to the lateral tubercle. The talus has a lateral process that articulates with the fibula and subtalar joint; the calcaneus possesses a frequently injured anterior process that articulates with the cuboid. Injury to these hindfoot structures is caused by inversion and eversion of the ankle, which can occur during athletic activity. These injuries often are misdiagnosed as ankle sprains. A high degree of clinical suspicion is warranted, and specialized radiographs or other imaging modalities may be required for accurate diagnosis. Nonsurgical management with cast immobilization is frequently successful when the fracture is correctly diagnosed acutely. Large fragments may be amenable to open reduction and internal fixation. Untreated, chronic injuries can cause significant pain and functional impairment that may be improved substantially with late surgical intervention.

Calcaneus↗
PubMed1990

Os trigonum syndrome.

The os trigonum is a frequently encountered accessory bone of the foot. It is located at the posterior aspect of the talus, and may appear either as a separate ossicle or fused to the talus. The separate ossicle may represent an accessory bone or a fracture of the posterior process (also called the trigonal process) of the talus. The author reviews the mechanism of injury and the diagnosis and treatment. A case report of a fracture of the trigonal process is presented.

Adult↗
PubMed1999

Clubfoot analysis with three-dimensional foot models.

The purpose of this study was to develop a method of defining, in mathematical terms, the interpositional relationships of the bones of the hindfoot complex in the idiopathic clubfoot and the neurogenic clubfoot. The neurogenic clubfoot and contralateral normal-appearing foot of a stillborn infant with myelomeningocele, and the normal foot of a 10-year-old were sectioned with a cryomicrotome. Magnetic resonance images (MRIs) of the clubfoot and the normal foot of a 3-month-old boy were obtained. Using a computer program, three-dimensional foot models were generated from the digitized cryomicrotome sections and from the MRIs. The central principal axes were determined for the talus and calcaneus. The long central principal axes of the talus and calcaneus were neutrally rotated with reference to the bimalleolar axis in the idiopathic clubfoot while in the neurogenic clubfoot the long central principal axis of the talus was medially rotated 52 degrees and that of the calcaneus 10 degrees. The talocalcaneal angles defined by the long central principal axes in the superior and medial views were 0 degree and 10 degrees, respectively, in the idiopathic clubfoot, and 42 degrees and 56 degrees, respectively, in the neurogenic clubfoot.

Biomechanical Phenomena↗
PubMed2000

Open total talar dislocation--report of two cases.

Total dislocation of talus from all its surrounding joints (tibiotalar, subtalar and talonavicular) is an extremely rare injury. Because of its rarity, only few case reports can be found in the literature. In the review of the literature, infection and AVN are the most commonly encountered complications that affect the outcome of these severe injuries. Herein we report two cases of open total talar dislocation. Immediate debridement, reduction of the talus, and primary skin closure was done followed by cast immobilization. After more than 2 years follow up, neither infection nor AVN was found. We conclude that reimplantation of the talus is preferable if the wound is relatively clean. Talectomy, or combined with tibiocalcaneal fusion should be reserved for later salvage procedure.

Adult↗
PubMed1992

Assessment of the posterior malleolus as a restraint to posterior subluxation of the ankle.

We assessed the function of the posterior malleolus, the anterior tibiofibular ligament, and the fibula with regard to posterior stability of the talus in ten ankles of cadavera. Posteriorly directed loads of as much as 200 newtons were applied. Two groups of ankles were tested; in the first group, three ankles in which the ligamentous and osseous structures were intact were tested after transection of the posterior capsule and after removal of 10, 20, 30, and 40 per cent of the articular surface of the distal end of the tibia from the posterolateral corner. In the second group, seven ankles were tested in the same sequence, but the anterior tibiofibular ligament and the fibula were transected before sectioning of the articular surface. Compared with the results for the intact ankle, the experiments on the first group demonstrated less than one millimeter of additional posterior translation of the talus after removal of as much as 40 per cent of the articular surface. In the second group, in which the anterior tibiofibular ligament and the fibula had been transected, significant posterior translation of the talus (more than three millimeters) occurred after removal of 30 per cent of the articular surface (p < 0.01). This represented a 160 per cent increase in translation compared with that in the intact ankle.

Aged↗
PubMed1988

Measurements on radiographs of the foot in normal infants and children.

Radiographs were made of the feet of seventy-four normal infants and children who ranged in age from six to 127 months, and various angles were measured. Means and deviations of the measurements were calculated for eleven clinically useful angles. On the anteroposterior radiographs the talocalcaneal, talus-first metatarsal, and calcaneus-fifth metatarsal angles were recorded, and on the lateral radiograph the talocalcaneal, tibiocalcaneal, tibiotalar, talus-first metatarsal, and talohorizontal angles were documented. On lateral radiographs that were made with the foot in maximum dorsiflexion, the talocalcaneal and tibiocalcaneal angles were documented and the talocalcaneal index was recorded. The mean values and the ranges of normal values changed with age. These data provide a standard for assessment of initial and residual deformity in patients who have club foot, vertical talus, metatarsus adductus, or other deformities.

Calcaneus↗
PubMed2006

Hindlimb adaptations in Ourayia and Chipetaia, relatively large-bodied omomyine primates from the Middle Eocene of Utah.

North American omomyids represent a tremendous Eocene radiation of primates exhibiting a wide range of body sizes and dietary patterns. Despite this adaptive diversity, relatively little is known of the postcranial specializations of the group. Here we describe hindlimb and foot bones of Ourayia uintensis and Chipetaia lamporea that were recovered from the Uinta B member (early Uintan Land Mammal Age), Uinta Formation, Utah. These specimens provide insights into the evolution of postcranial adaptations across different body sizes and dietary guilds within the Eocene primate radiation. Body mass estimates based on talar measurements indicate that Ourayia uintensis and Chipetaia lamporea weighed about 1,500-2,000 g and 500-700 g, respectively. Skeletal elements recovered for Ourayia include the talus, navicular, entocuneiform, first metatarsal, and proximal tibia; bones of Chipetaia include the talus, navicular, entocuneiform, and proximal femur. Both genera had opposable grasping big toes, as indicated by the saddle-shaped joint between the entocuneiform and first metatarsal. Both taxa were arboreal leapers, as indicated by a consistent assemblage of characters in all represented bones, most notably the somewhat elongated naviculars, the high and distinct trochlear crests of the talus, the posteriorly oriented tibial plateau (Ourayia), and the cylindrical head of the femur (Chipetaia). The closest resemblances to Ourayia and Chipetaia are found among the Bridger omomyines, Omomys and Hemiacodon. The results of our comparisons suggest that the later, larger, more herbivorous omomyines from Utah retained a skeletal structure characteristic of earlier, smaller North American omomyids.

Adaptation, Physiological↗
PubMed2007

Quantitative and topographical evaluation of ankle articular cartilage using high resolution MRI.

The objectives of this study were to quantitatively evaluate the articular cartilage layers of the ankle and describe the cartilage topographical distribution across the joint surfaces using high resolution MRI and image segmentation. An anisotropic diffusion noise reduction algorithm and a directional gradient vector flow (dGVF) snake segmentation algorithm were applied to cartilage sensitive MR images. Eight cadaveric ankles were studied. Six repeated data sets were acquired in five of the ankles. Quantitative parameters were calculated for each cartilage layer; coefficients of variation (CV) were calculated from the six repeated data sets; and 3D thickness distribution maps were generated. The noise reduction algorithm produced marked image enhancement. Mean cartilage thickness ranged from 0.91 +/- 0.08 mm in the fibula to 1.34 +/- 0.14 mm in the talus. Mean cartilage volume was 3.32 +/- 0.55 ml, 1.72 +/- 0.25 ml, and 0.35 +/- 0.06 ml for the talus, tibia, and fibula, respectively. Mean CV ranged 2.82%-5.04% for quantitative parameters in the talus and tibia. The reported noise reduction and segmentation technique allow precise extraction of ankle cartilage and 3D reconstructions show that the thickest cartilage occurs over the talar shoulders, where osteochondritits dissecans (OCD) lesions commonly occur.

Algorithms↗
PubMed1982

Long-term prognosis of tarsal dislocations.

Eighty tarsal dislocations treated between 1954 and 1979 are presented. Our of 48 cases reviewed after a mean follow-up time of 7 years, satisfactory results were achieved in 30 (62%). Osteonecrosis of the talus was not recorded whereas necrosis of the navicular developed in 5 patients. Failures are to be related to significant osteoarthritic changes which occurred after a long period particularly in compound injuries with associated fractures of the tarsal bones. Early closed reduction and immobilization in a below-knee cast for 4 weeks is recommended in pure luxation; associated fractures of the talus and navicular require surgical fixation as far as possible. Except in total open dislocation of talus or navicular replacement was by far preferred to removal and primary arthrodesis.

Adolescent↗
PubMed2005

[The dorsolateral approach to the ankle for arthrodesis].

OBJECTIVE: Bony fusion of the ankle in functional position. Restitution of a pain-free use of the limb. INDICATIONS: Joint destruction not amenable anymore to conservative treatment modalities. Chronic instabilities of diverse causes. CONTRAINDICATIONS: Severe general and metabolic diseases. Extensive scarring at the posterior aspect of the ankle. SURGICAL TECHNIQUE: Posterolateral approach to the ankle. Fibular osteotomy and resection of a 1 cm long bone block from its diaphysis. Removal of articular cartilage of tibia, talus, and lateral malleolus. Plantigrade positioning of the talus under the tibia in slight external rotation. Internal tibiotalar screw fixation. Fixation of the lateral malleolus to tibia and talus with screws. POSTOPERATIVE MANAGEMENT: Plaster cast for 2 weeks without weight bearing followed by partial weight bearing in an ankle-foot orthesis with a rocker-bottom sole until radiologic evidence of bony fusion. RESULTS: 26 patients (21 men, five women, average age 55 years (21-83 years) underwent a total of 29 ankle arthrodeses. Minimum clinical and radiologic follow-up of 1 year. All patients were able to bear full weight between the 2nd and 3rd postoperative month. All patients could be reached by telephone 1-14 years after surgery. Screws had been removed in six of the patients. The activities of daily living were assessed on a visual analog scale (0-10 points); they had improved from 2.5 points preoperatively to 8.3 points postoperatively. All patients stated they would undergo this operation again. 16 patients were physically active and participated in sports such as bicycling, hiking and swimming.

Adult↗
PubMed2003

[The role of the tibiofibular syndesmotic and the deltoid ligaments in stabilizing Weber B type ankle joint fractures--an experimental investigation].

The purpose of the present biomechanical investigation was to check the functional importance of the syndesmosis ligaments and of the deltoid ligament for ankle fracture type B according to the AO-Weber classification. We constructed a special fixation clamp, with 12 fresh and unembalmed lower legs being tested for lateral shift (mm) and ten for tibiotalar rotation. All specimens were exposed in the same neutral position. Transverse loads (F(y)) varied between 0 and 150 N, axial loads (F(z)) between 0, 300, 600 and 1,000 N and rotational loads (F(r)) between 2.4 and 4.9 Nm. All series were repeated according to supination-eversion (SE) injury patterns of the Lauge-Hansen classification. Syndesmotic ligaments and the fibula were incrementally sectioned from anterior to posterior. Type SE I consisted of an isolated incision of the anterior syndesmosis ligament. Type SE II had an additional oblique fracture of the fibula at the height of the tibiofibular syndesmosis. In type SE III injuries, in addition to the fibular fracture, a complete rupture of the syndesmosis ligaments was present, and for type SE IV lesions the deltoid ligaments were incised. The transverse load-displacement curve was s-shaped in all uninjured joints,with the highest gradient between 10 and 20 N with no axial compression. Without axial compression in cases of F(y)=25 N transverse loads, the mean talus translation was 0.51 mm. Following type II injuries, the average talus translation was 0.68 mm (not significant) and rose to an average of 0.95 mm ( P <0.01) in type III injuries. After additional incision of the deltoid ligaments, the ankle joint subluxed permanently when more than 5-10 N transverse loads were applied. Axial loads of 300 N or more resulted in a considerable reduction in talus translations, indicating increased stability and congruency within the joint complex. In this way, the vertical loading of the ankle joints always contributed to joint stability. The average internal tibiotalar rotation reached with a torque of 2.4 Nm was 3.52 degrees and with 4.9 Nm 5.15 degrees when no axial compression was applied. External rotation measured -6.36 degrees and -8.62 degrees, respectively. Following the experimental protocol, significant increases were noted for external rotation at SE II degrees injuries ( P =0.003) and for internal rotation at SE III degrees ( P =0.03) injuries. Our data support the proposition that the deltoid ligaments and the posterior syndesmosis play a key role in the stability of ankle fractures for supination-eversion injuries. If these structures remain intact, conservative and early functional treatment are recommended in patients with minimal (<2 mm) or no fracture displacement. This concept is confirmed by the literature dealing with clinical mid- and long-term follow-up studies.

Ankle Injuries↗
PubMed1999

[Tibiocalcaneal fusion for the treatment of talar necrosis. An analysis of 21 cases].

Between 1986 and 1996, 21 patients had a tibiocalcanear arthrodesis. Indications for surgery were in all cases either osteomyelitis or avascular necrosis of the talus. External stabilisation was used in 17 patients due to severe soft tissue damage or extensive infection of the talus, internal screw fixation was used in four patients. There were eight complications in seven patients, one patient had a below the knee amputation. The leg length discrepancies after resection of the talus was equalized in four cases with callus distraction using an Ilisarov ring fixator. Follow up evaluation was available in 18 patients after an average of 38 months (12-86 mo.). There were no infectious recurrencies during the follow up period and a solid fusion was achieved in all patients that were followed. According to a modified Kitaoka score, results were excellent and good in 12 of the 18 patients. External stabilisation, especially the Ilisarov ring fixator is the primary method of treatment in cases with severe infection or soft tissue damage.

Adult↗
PubMed2000

Features of calcaneonavicular coalition on coronal computed tomography.

OBJECTIVE: To determine the findings of calcaneonavicular coalition on coronal CT. DESIGN: We retrospectively reviewed the CT scans of 14 calcaneonavicular coalitions in eight patients. All coalitions were visible on the axial scans, and the diagnosis was confirmed by surgery in five patients. These CT scans were compared with scans of ten normal feet. RESULTS: We identified two features of calcaneonavicular coalition on coronal CT: lateral bridging (an abnormal bony mass lateral to the head of the talus) and rounding of the talus. All eight patients demonstrated at least one of these two findings. CONCLUSION: Although calcaneonavicular coalition is best seen on axial CT scans of the feet, there are two abnormalities, lateral bridging and rounding of the head of the talus, which should suggest the diagnosis on coronal CT scans.

Adolescent↗
PubMed2006

MRI in long-term evaluation of reconstructed hind-feet of land-mine trauma patients.

INTRODUCTION: The purpose of this study was to assess the flap reconstructed hind feet of patients with MRI who were traumatized by land-mine. MATERIALS AND METHODS: T1 and T2 weighted images were obtained in 7 patients, 12 months later the reconstruction of their hind feet by myocutaneous flaps after land-mine trauma. RESULTS: In all patients T2 signal intensities of the myocutaneous flaps were slightly high compared to normal undisturbed muscle. Slight vascular engorgement was noted in the vicinity of the flaps in all cases. There were ankle joint ankylose (n=1), tarsal coalition (n=3), sklerosis within the calcaneus (n=1), bone cortex irregularities (n=3), absence of calcaneus (n=4), deformity in talus and bone marrow edema (n=1), navicular edema (n=2), remodeling in the superior aspect of talus neck (n=2), absence of talus (n=2), talocalcaneal ankylose (n=1), small collection in the superior aspect of flap (n=1), drenage canules (n=1). CONCLUSION: In reconstructed hind feet by myocutaneus flaps done for land-mine traumas, MRI presents useful information by displaying detailed anatomy of the flaps, bones, joints, soft tissues and associated complications.

Adult↗