Subtalar joint instability.
OBJECTIVE
Subtalar joint instability may frequently be overlooked and erroneously be integrated under the diagnosis of ankle joint instability. It was the scope of this review to characterize the present state-of-art with regard to the adequate diagnosis and treatment.


METHODS
While the clinical picture is mostly inconclusive for subtalar joint instability, a high degree of suspicion for this diagnosis is needed to employ weight-bearing x-rays, standardized stress radiography, CT scanning and MRI to further elucidate the etiopathology


RESULTS
Geometrical reasons as hindfoot deformities, isolated or combined injuries or instabilities in conjunction with the ankle ligament complex do exist which should be differentiated in detail and classified to indicate the adequate treatment. Treatment of acute lesions is simple and effective. A certain percentage of the patients with chronic subtalar instability is incorrectly labeled with the diagnosis of a sinus tarsi syndrome.


CONCLUSIONS
Subtalar joint arthroscopy for reconfirmation of the correct diagnosis conjoined with restoration of physiological hindfoot alignment and a preferably anatomical ligamentous reconstruction provide the basis for a good functional recovery.
Chirurgische Klinik und Poliklinik, Abt. für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsmedizin Rostock, Schillingallee 35, 18055, Rostock, Germany. thomas.mittlmeier@med.uni-rostock.de.
Thomas
T
Mittlmeier
Chirurgische Klinik und Poliklinik, Abt. für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsmedizin Rostock, Schillingallee 35, 18055, Rostock, Germany.
Alice
A
Wichelhaus
D000208:Acute Disease; D001182:Arthroscopy / Q000379:methods; D001696:Biomechanical Phenomena / Q000502:physiology; D001863:Bone Screws; D002908:Chronic Disease; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008023:Ligaments, Articular / Q000293:injuries* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D009989:Orthotic Devices; D010808:Physical Examination; D012421:Rupture / Q000175:diagnosis / Q000601:surgery; D013380:Subtalar Joint / Q000293:injuries / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016474:Weight-Bearing / Q000502:physiology
Fibulocalcaneal ligament; Interosseous talocalcaneal ligament; Subtalar instability; Subtalar joint; Surgical reconstruction