Subtalar joint dislocation is a relatively rare injury, with lateral dislocation occurring less frequently than medial dislocation. Associated fractures alter the treatment plan and the prognosis, but they are often missed on plain film radiographs. A brief review of the anatomy, pathomechanics, treatment, prognosis, and complications of subtalar joint dislocation is presented. An interesting case of lateral subtalar joint dislocation with an associated calcaneal fracture not evident on plain film radiographs but delineated with computed tomography is presented. (J Am Podiatr Med Assoc 94(1): 65-69, 2004)
Tarsal coalitions represent a cohort of conditions characterized by bony, cartilaginous, or fibrous union of two or more tarsal bones. These disorders are often poorly understood by medical professionals, often leading to delays in diagnosis and treatment. They may be asymptomatic or cause hindfoot pain, stiffness, decreased range of motion, and foot deformities. Coalitions can be investigated by an ascending sequence of imaging including radiography, computed tomography, and magnetic resonance imaging. They may be managed conservatively with orthoses, activity modification, physiotherapy, anti-inflammatory medications, or definitive surgical intervention. To our knowledge, cuboid-lateral cuneiform coalition has not been reported in the orthopedic literature. We describe a 40-year-old woman with this condition who reported a 1-year history of left foot pain and stiffness. She was definitively diagnosed with magnetic resonance imaging and was managed conservatively with an aircast boot and hydrocortisone injection.
Congenital absence of the lateral sesamoid is an extremely rare condition. We present a case of congenital absence of the lateral sesamoid in which magnetic resonance imaging was performed. The literature is reviewed regarding the clinical significance of this anomaly. (J Am Podiatr Med Assoc 96(1): 78–81, 2006)
The three (medial, intermediate, and lateral) cuneiforms and their articulations in the foot are small and relatively well protected from injury. An isolated fracture of the lateral cuneiform is a rare finding. However, isolated injuries may occur as the result of direct trauma. We report a case of an isolated fracture of the lateral cuneiform that was not seen on initial radiographs and only became evident on plain radiographs 4 weeks after the injury. As each of the cuneiform bones articulates with four other bones in the midpart of the foot, persistent displacement of any fracture (subluxation or dislocation) may result in post-traumatic arthritis. We believe that in suspected cases with negative radiographic findings, further imaging (computed tomography or bone scanning) should be requested. Without the use of additional imaging techniques, many fractures may be misdiagnosed as ankle sprains or foot contusions, and patients may be discharged from the hospital. (J Am Podiatr Med Assoc 97(6): 483–485, 2007)
Stress fractures are common overuse injuries of the bone that are most often seen in athletes and military personnel. These types of injuries seem to be commonly missed or delayed in diagnosis. Physicians should consider the possibility of such an injury while determining the diagnosis of a long-lasting foot pain. The aim of this paper was to report an isolated stress fracture of the lateral cuneiform bone. A review of the literature failed to find a similar case. (J Am Podiatr Med Assoc 103(4): 337–339, 2013)
The modified Brostrom procedure has been a proven procedure with excellent utility in the treatment of lateral ankle instability within limitation. Multiple variations of the original technique have been described in the literature to date. Included in these variations are differences in anchor placement, suture technique, or both. In this research study, we propose placing a bone screw anchor into the lateral shoulder of the talus rather than the typical placement at the lateral malleolus for anatomic reconstruction of the lateral ankle ligaments. (J Am Podiatr Med Assoc 98(6): 473–476, 2008)
The lateral intermetatarsal angle, a measurement of the sagittal plane angular divergence between the dorsal cortices of the first and second metatarsals of lateral weightbearing foot radiographs, was compared in 30 normal and 30 hallux limitus feet. The results suggest that the angle may be measured reliably and that although the measured angles are relatively small, a significant difference exists between the normal and hallux limitus subjects studied. Accordingly, the lateral intermetatarsal angle may prove to be a useful radiographic measurement to assist the podiatric physician in the clinical assessment of hallux limitus. (J Am Podiatr Med Assoc 91(5): 251-254, 2001)
Tarsal coalitions typically occur at the talocalcaneal or calcaneonavicular joints. Common findings are pain, limited range of motion, and a pes planus deformity. The focus of this case report includes the presentation, imaging, treatment, and outcomes for a 21-year-old woman diagnosed with a rare lateral cuneocuboid coalition with chronic pain. Clinical and radiographic examinations, typically used to diagnose the common coalition, were unremarkable. Magnetic resonance imaging was diagnostic of the lateral cuneocuboid coalition, which was successfully treated with surgical resection. At 6-year follow-up, she reports resolution of symptoms and has returned to her normal presurgical activity level pain-free. This case is only the third lateral cuneocuboid coalition reported in the literature. The rarity of this coalition and its nonsuspicious clinical presentation make it worthy of acknowledgment.
Sural nerve impingement is frequently reported and often arises from localized trauma but much less understood are its mechanical etiologies. This case report describes the effects of local traction on the lateral calcaneal branch of the sural nerve. The association is confirmed anatomically and symptoms are alleviated with a heel lift. (J Am Podiatr Med Assoc 102(1): 75–77, 2012)
We present a case of tibial pilon fracture where only the lateral part of the distal tibia was affected. The transfibular approach to the ankle was used for the surgical treatment of the fracture. After an initial nonweightbearing period of 3 weeks, full weightbearing was allowed 8 weeks after surgery. The second-year follow-up showed no evidence of degenerative signs, with full ankle range of motion.