![]() ![]() The posterior tibial nerve, artery, vein, and posterior tibialis, flexor hallicus longus, and flexor digitorum longus tendons are inside of the tarsal tunnel, and the posterior tibial nerve has the potential to become entrapped within the space Tarsal Tunnel Syndrome occurs on the ankle's medial aspect, the tarsal tunnel forms a bony floor consisting of the tibia, talus, and calcaneus, and a fibrous roof consisting of the fibrous flexor retinaculum. One percent of all ankle sprains cause avulsion fractures of the talus, so it’s important to consider them in the differential diagnosis when patients present with symptoms a lateral ankle sprain, especially if patients have marked swelling, bruising, or difficulty weight-bearing.Due to the attachment of the ATFL and PTFL on the talus, avulsion fractures of the talus may occur when those ligaments suffer injury in lateral ankle sprains.Lateral ankle sprains are the most common athletic injury, constituting 15 to 20% of all athletic injuries, and 85% of all ankle sprains. Talar body fractures make up 20% of all talar fractures, and if a fracture extends through an articulating surface on the talar body, sequelae of osteoarthritis can occur.Īvulsion Fractures of the Talus.Talar fractures make up one percent of all foot and ankle fractures, and the most common (around 50%) talar fractures occur in the talar neck, the weakest part of the talus.Ĭlinical Significance Avascular Necrosis (AVN) įractures of the talus have a high risk of developing AVN due to its inherently tenuous and limited blood supply. It forms the tarsal sinus with the calcaneal sulcus of the calcaneum. The inferior surface of the talar neck has a deep groove, the sulcus tali, that passes obliquely forward and expands from medial to lateral.The talar head and body are connected by the talar neck, which is inclined downwards distally and medially. There is another facet, medial to the above facets, for articulation with the spring ligament. There are anterior and middle facets which articulate with corresponding facets on the calcaneus. On its inferior aspect, this is continuous with three articular facets that are separated by smooth ridges. The talar head is the part that articulates with the navicular bone.The posterior aspect has a backward and medially facing posterior process, which has a lateral and medial tubercle separated by a groove for the tendon of flexor hallucis longus. The lower part of the lateral surface forms a bony projection called the lateral process which supports the lower portion of the lateral articular facet. The lateral articular surface is large and projects more inferiorly. The medial and lateral surfaces articulate with the medial malleolus (of the tibia) and lateral malleolus (of the fibula) respectively. The talar body has a curved smooth trochlear surface also termed the talar dome, which is covered with hyaline cartilage and convex from front to back.The talus has seven articular surfaces and is divided into the head, neck and body, and two processes, the posterior process and the lateral process.Approximately two-thirds of its surface area is covered with articular cartilage and it has a tenuous blood supply, similar to the scaphoid.The talus is shaped like a truncated cone and is wider anteriorly than posteriorly (it is an irregular saddle-shaped bone).The talus is an incredible bone despite its small size, it transmits considerable force during the normal gait cycle and even more significant force during impact activities. ![]()
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