Accessory talar facet impingement

NewsBot · Apr 15, 2015

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Peroneal spastic flatfoot in adolescents with accessory talar facet impingement: a preliminary report
Niki, Hisateru; Aoki, Haruhito; Hirano, Takaaki; Akiyama, Yui; Fujiya, Hiroto
Journal of Pediatric Orthopaedics B: in press

This study analyzed imaging, arthroscopic findings, and treatment responses for peroneal spastic flatfoot (PSFF) caused by talocalcaneal impingement at the accessory anterolateral talar facet (AALTF) (accessory talar facet impingement) in 13 adolescents without histories of trauma and tarsal coalition. The AALTF was determined with computed tomography and MRI. Focal abutting bone marrow edema (FABME) on MRI around the AALTF was confirmed. In seven patients who underwent AALTF resection, subtalar arthroscopy was performed. All experienced alleviation PSFF after treatment; reduction in FABME was observed. AALTF resection alone is beneficial for PSFF caused by accessory talar facet impingement when peroneal spasms are restored by an injection of local anesthesia.
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Admin2 · Apr 15, 2015

Related Threads:
Other threads tagged with peroneal spastic flatfoot
TLAP = "too long" anterior process of calcaneus

NewsBot · Aug 15, 2019

Accessory anterolateral talar facet associated with tarsal coalition: prevalence and cross-sectional characterization.
Alqahtani E et al
Skeletal Radiol. 2019 Aug 12

OBJECTIVE:
The accessory anterolateral talar facet (AALTF) is a developmental entity described as a potential cause for rigid, painful flat foot. This study evaluates the possible association between the AALTF and other flat foot etiologies, specifically different types of tarsal coalitions.

MATERIALS AND METHODS:
We evaluated patients with tarsal coalition or sinus tarsi syndrome for an AALTF on CT and MRI. Exclusion criteria included acute ankle trauma, recent surgery, motion or metal artifacts. We evaluated the AALTF length and height, and the lateral talocalcaneal structures for associated findings. The presence of calcaneonavicular (CNC), intra-articular middle facet talocalcaneal (MFTCC), posterior facet talocalcaneal (PFTCC), extra-articular posteromedial talocalcaneal (EATCC) and other rare coalitions were also evaluated.

RESULTS:
One hundred eighty-seven patients were included (age range 14-91 years; mean ± SD; 50 ± 17 years). The AALTF prevalence in the study population was 31.55% (59/187), 40.91% in men, and 23.23% in women. The AALTF average length was 4.5 ± 1.1 mm, and average height was 8.9 ± 3.4 mm. The AALTF was found to be significantly associated with lateral talocalcaneal osseous changes such as cortical thickening and cystic changes (34/59 and 24/59 respectively, P < 0.01). The AALTF was also found to be significantly associated with sinus tarsi edema on MRI (45/52, P < 0.05). The AALTF was also significantly associated with EATCC (19/59, P < 0.01) and MFTCC (7/59, P < 0.05). No significant association was found with CNC, PFTCC or other rare coalitions.

CONCLUSION:
The AALTF is common and significantly associated with some tarsal coalitions, specifically EATCC and MFTCC. When an AALTF or coalition is identified, special attention should be made to evaluate for other associated pathologies, as this could potentially affect management.
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NewsBot · Dec 3, 2019

Correlation between the accessory anterolateral talar facet, bone marrow edema, and tarsal coalitions
Josephina A. VossenMashya AbbassiYanjun QianCurtis W. HayesPeter J HaarKevin B Hoover
Skeletal Radiology: 29 November 2019

Objective
The purposes of this study was to determine the prevalence of the accessory anterolateral talar facet (AALTF); to evaluate the relationship between AALTF, focal abutting bone marrow edema (FABME), and sinus tarsi edema; and to study the prevalence of tarsal coalitions in patients with the AALTF utilizing ankle MR images.

Materials and methods
5-T ankle MR images were reviewed for the presence of AALTF, FABME, sinus tarsi edema, tarsal coalition, and location and type of coalition (cartilaginous, fibrous, and osseous). Multivariate analysis was performed to examine the correlation between AALTF and the other variables.

Results
Three hundred ninety-one consecutive patients were included (age range 5–86 years; mean age 45 years). An AALTF was present in 3.6% (14/391) of patients. The AALTF prevalence was 2% in women and 6.6% in men. There was a significantly association between AALTF and FABME (9/14, p < 0.05), sinus tarsi edema (13/14, p < 0.05), and tarsal coalition (4/14, p < 0.05).

Conclusion
AALTF is relatively often detected on MRI of the ankle and significantly associated with BME, sinus tarsi edema, and subtalar coalition. Patients with a tarsal coalition should be evaluated for the concurrent presence of an AALTF
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NewsBot · Jan 27, 2020

Accessory Anterolateral Talar Facet Syndrome After Treatment of Neglected Fracture of the Lateral Process of the Talus: A Case Report.
Mui T et al
J Foot Ankle Surg. 2020 Jan 22

Fracture of the lateral process of the talus has often been missed or confused with lateral ankle sprain, and this can lead to long-term untreated cases of nonunion, malunion, and subtalar joint osteoarthritis. In a review of the published data, accessory anterolateral talar facet syndrome was not found after treatment of nonunion of the lateral process of the talus fracture. This report presents the case of a 40-year-old male snowboard instructor who suffered from a neglected fracture of the lateral process of the talus and was treated with open reduction using an iliac autogenous bone graft. Subsequently, partial resection of the anterior aspect of the process was required to treat the impingement syndrome that developed secondary to the united but enlarged lateral process. The patient resumed his activities a year after the second operation. We describe the consequences of misdiagnosis of the lateral process of the talus and its management.
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NewsBot · Jun 9, 2021

Accessory Talar Facet Impingement and Sinus Tarsi Pain Associated With Accessory Anterolateral Talar Facet
Jae Woo Park, MD, JeongJin Park, MD, Chul Hyun Park, MD, PhD
Foot & Ankle International May 22, 2021

Background:
Sinus tarsi pain caused by accessory talar facet impingement (ATFI) owing to accessory anterolateral talar facet (AALTF) is not well documented. We evaluated prevalence of AALTF and differences of magnetic resonance imaging (MRI) findings between persons with and without sinus tarsi pain, and investigated the relevant association between MRI findings and sinus tarsi pain in persons with AALTF.

Methods:
We performed a case-control study on 120 ankles with sinus tarsi pain and 120 age- and gender-matched ankles without sinus tarsi pain. As MRI findings, bone marrow edema (BME), sinus tarsi fat obliteration (STFO), calcaneal cyst, talocalcaneal coalition, Gissane angle, talar inferolateral surface (TILS) angle, and calcaneal cortical thickness (CCT) were evaluated. The MRI findings were compared between persons with and without sinus tarsi pain, and between persons with and without AALTF. Among persons with AALTF, MRI findings were compared between those with and without sinus tarsi pain. Relevant association was evaluated between MRI findings and sinus tarsi pain in persons with AALTF.

Results:
Presence of AALTF, BME, and STFO were significantly higher in the group with sinus tarsi pain. The Gissane angle was significantly smaller, and the TILS angle and CCT were significantly larger in the group with sinus tarsi pain. The BME (OR 7.571, CI 1.453-39.446) and small Gissane angle (OR 0.891, CI 0.804-0.986) were significantly associated with sinus tarsi pain in persons with the AALTF.

Conclusion:
The study provides evidence for ATFI related to impingement of an AALTF associated with talocalcaneal BME.
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NewsBot · Sep 26, 2022

Mini-open Arthroplasty for
Anterior Ankle Impingement
Steven R Edwards, Mark F Gilheany, Nicholas D Ryan
International Journal of Anatomy Radiology and Surgery. 2021 Apr, Vol-10(2): SC01-SC03

Osseous or soft tissue impingement of the anterior ankle can result in reduced dorsiflexion, pain and difficulty in walking that can
significantly reduce the quality of life. Sometimes, conservative treatments fail and surgical intervention may be indicated. A 34-
year-old male, who sustained a severe ankle injury five years back whilst waterskiing, complained of ongoing pain and disability. His
initial injury had resulted in multiple fracture fragments within the anterior and posterior aspects of his right ankle. Upon performing
clinical examination, reduced dorsiflexion with crepitus was noted and plain film radiographs exhibited multiple fragments within
the anterior and posterior aspects of his ankle joint. Pain and limitation to motion were primarily affecting the anterior joint.
The posterior aspect was only mildly symptomatic and not considered a primary consideration. Treatment involved a mini-open
arthroplasty with removal of the osteophytes and margination of the chondral defects. Adequate dorsiflexion without crepitus was
noted on the operating table and postoperative radiographs showed adequate removal of the osteophytes. He was kept nonweight bearing in a fibreglass back slab for 10 days before resuming partial weight bearing in a postoperative shoe and crutches.
Mini-open arthroplasty may offer a viable alternative to large incision joint procedures or arthroscopy and may be a procrastinatory
procedure for patients wishing to delay ankle joint arthrodesis or replacement.
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