Thirteen patients presenting with symptomatic pathologic variations or congenital deformities of the subtalar joint are presented. These variations included: four abnormal posterior talar processes, five patients with asymmetric subtalar joint development, and four congenital complete subtalar coalitions with a secondary ball-and-socket joint. In each case these adult patients had been unaware of the variation and had been symptom free until “awakening” sprain or fracture trauma brought about symptoms. The nonoperative and operative management of these variations is reviewed.
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References
1.
. BennettE.H.: On the ossicle occasionally found on the posterior border of the astragalus. J. Anat. Physiol., 21: 59–65, 1887.
. CowellH.R.: Talocalcaneal coalition and new causes of peroneal spastic flat foot. Clin. Orthop., 85: 16–70, 1972.
4.
. DuboisH.J.: Nievergelt-Pearlman syndrome: synostosis in feet and hands with dysplasia of elbows: report of a case. J. Bone Joint Surg., 52B: 325–326, 1970.
5.
. HamiltonW.G.: Stenosing tenosynovitis of the flexor hallucis longus tendon and posterior impingement upon the os trigonum in ballet dancers. Foot Ankle, 3: 74–80, 1982.
6.
. HarrisB.J.: Anomalous structures in the developing human foot (abstr). Anat. Rec., 121: 399, 1955.
7.
. HarrisR.I.: Retrospect: peroneal spastic flat foot. J. Bone Joint Surg., 47A: 1657–1658, 1965.
8.
. HerzenburgJ.E.GoldnerJ.L.MartinezS.SilvermanP.M.: Computerized tomography of talocalcaneal tarsus coalition: a clinical and anatomic study. Foot Ankle, 6: 273–288, 1986.
9.
. KitaokaH.B.AlexanderI.J.AdelaarR.S.NunleyJ.A.MyersonM.S.SandersM.: Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int., 15: 349–353, 1994.
10.
. LambD.: The ball and socket ankle joint. J. Bone Joint Surg., 40B: 240–242, 1958.
11.
. MannR.A.: Surgery of the Foot, 5th ed.St. Louis, C. V. Mosby, 1986, pp. 704–705.
12.
. MannR.A.CoughlinM.J. (eds.): Surgery of the Foot and Ankle, 6th ed.St. Louis, C. V. Mosby, 1993, p. 15.
13.
. McDougallA.: The os trigonum. J. Bone Joint Surg., 37B: 257–265, 1955.
14.
. MunkP.L.VelletA.D.LevinM.F.HelmsC.A.: Current status of magnetic resonance imaging of the ankle and hindfoot. Can. Assoc. Radiol. J., 43: 19–30, 1992.
15.
. PfitznerW.: Die Variationen im Aufbar des Fussekelts Bertrage zur Kenntniss des menschlichen Extremitalenshelets VII. Morphol. Arbeit., 6: 245, 1896.
16.
. PierrynowskiM.R.SmithS.B.: Rear foot inversion/eversion during gait relative to the subtalar joint neutral position. Foot Ankle Int., 17: 406–412, 1996.
17.
. SarrafianS.K.: Anatomy of the Foot and Ankle. Philadelphia, J. B. Lippincott, 1983.
18.
. SchruberA.DifferdingP.ZollingerH.: Talus partitus. J. Bone Joint Surg., 67B: 3, 1985.
19.
. ScottS.H.WinterD.A.: Talocrural and talocalcaneal joint kinematics and kinetics during the stance phase of walking. J. Biomech., 24: 752–763, 1991.
20.
. ScrantonP.E.: Treatment of coalition patients. J. Bone Joint Surg., 69A: 539–544, 1987.
21.
. SeniorH.D.: The chondrification of the human hand and foot skeleton (abstr). Anat. Rec., 42: 35, 1929.
22.
. ShepardF.J.: A hitherto undescribed fracture of the astragalus. J. Anat. Physiol., 18: 79–81, 1882.
23.
. SwintkowskiM.ScrantonP.E.HansenS.: Tarsal coalition: long term results of surgical treatment. Ped. Orthop., 3: 287–292, 1983.
24.
. TachdjianM.O.: The Child's Foot. Philadelphia, W. B. Saunders, 1986.
