$occult fracture$

It articulates with the talus superiorly, as well as with the cuboid and navicular anteriorly. The calcaneus is a complex, bony structure providing attachment for the Achilles posteriorly and the plantar fascia and plantar intrinsic muscles of the foot inferiorly. 14-8).įigure 14-8 A meniscus-like “marsupial meniscus” often noted in the posterior ankle superior to the posterior process of the talus. A meniscus-like “marsupial meniscus” also often exists in the posterior ankle superior to the posterior process of the talus ( Fig. The Y-shaped transverse or bifurcate ligament is a thickening in the posterior ankle capsule that holds the two tubercles together and restrains the flexor hallucis longus. The posterior deltoid or posterior talotibial ligament attaches the posterior tibia to the posteromedial tubercle of the talus. The posterior talofibular ligament attaches the fibula to the posterolateral tubercle or the os trigonum (see Fig. In approximately 7% to 10% of humans a separate os trigonum may exist-connected to the posterolateral tubercle by a fibrous cartilaginous synchondrosis ( Fig. The posterolateral tubercle (Stieda’s process) is larger than the posteromedial tubercle. Note the (A) posterior process of the talus, the (B) flexor hallucis longus between the two tubercles of the posterior talus, and (C) the posterior ligamentous anatomy. External athletic injuries to the talus that involve disruption of the vascular leash or the ligamentous attachments often produce vascular insult to the talar body or talar neck and may produce talar fractures or compression injuries that heal slowly or do not heal.įigure 14-6 Posterior anatomy of the talus. The internal vasculature of the talus varies considerably 4 ( Fig. Blood supply to the talus therefore is limited, 1, 3 coming from its ligamentous attachments and a leash of vessels surrounding the talar neck that receive contributions from the artery to the tarsal canal medially, the dorsalis pedis artery anteriorly, and the artery to the sinus tarsi laterally ( Fig. Approximately 60% to 70% of the talar surface is articular 1, 2 with the ankle joint superiorly, the talonavicular joint anteriorly, and the subtalar joint inferiorly. The talus is unique in that it has no direct muscular attachments. Note the attachment of the talus to the calcaneus via the (A) talocalcaneal and cervical ligaments and the talus to the navicular via the (A) dorsal and (B) plantar talonavicular ligaments. Figure 14-2 Hindfoot anatomy of the subtalar joint.

$occult fracture$

Occult fracture