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Noninvasive Quantification of Subtalar Joint Kinematics
A Pilot Investigation
A noninvasive method of assessing the motion of the subtalar joint was developed for use in clinical and research settings. Anatomical reference frames for the calcaneus and talus were produced using a marker placement model utilizing 14 markers. An asymptomatic individual was tested during barefoot walking with a CODA MPX30 system. Intertrial variability and motion patterns, in all three planes, of the calcaneus with respect to the talus were analyzed as part of a validation study. The observed patterns in all three planes were found to have good face validity with published literature as well as good consistency during stance. The findings of this study support the further use of this model in both clinical and research settings, allowing investigation of the motion patterns of a larger cohort than has hitherto been possible.
Ankle injuries can lead to early osteoarthrosis when diagnosis is delayed. The clinical presentation of an osteochondral lesion of the talar dome is often difficult to diagnose in the initial setup of an ankle sprain or fracture. Once the lesion is adequately imaged and staged, open or arthroscopic treatment can be initiated. We discuss the arthroscopic treatment of a posteromedial talar dome lesion in this case report. Transmalleolar drilling was performed to treat an osteochondral lesion of the talar dome in a 24-year-old female. Her ankle evolved toward a severe clinical and radiologic condition in which a combined talar and tibial (kissing) lesion was seen during her follow-up. Therefore, we recommend the use of retrograde drilling or arthroscopic microfracture with minimal iatrogenic risk, instead of transmalleolar drilling, as the treatment of choice in these specific osteochondral lesion of the talar dome cases. (J Am Podiatr Med Assoc 99(1): 54–57, 2009)
