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Is it possible for the talus to become posteriorly subluxed? In gross terms I mean, not a subtle subluxation (if there is such a thing)

What restriction would it create at the talo crural joint?

Could it be seen radiographically?

Many thanks for your consideration. I'm trying to work through a problem and I'm not sure that my logic is correct so any help is appreciated.

Robin

 

Not sure I follow- If it was gross, would it be a dislocation?
You would also have to put it in context- do you mean posteriorly shifted in the ankle mortice? Why have you called this post 'dorsiflexion blockage'- wouldn't it more likely cause a plantar flexion blockage (posterior impingement)?

 

Hi Craig,

Yes

That is my problem. The report I have been given by an osteopath is stating that the patient had a posteriorly subluxed talus following a forced plantarflexion injury - which according to my reading is more likely to cause an anterior subluxation.

The osteopath has been trying to keep the talus forward. Clinically, my examination showed talo crural dorsiflexion restriction with a Lunge test of 60mm(no inclinometer that day). That would tie in much more with the pattern of injury.

Doesn't make a difference to how I am going to treat orthotically but I think the patient needs to see a foot ankle consultant and I would like to get some radiographs via the GP. The waiting list will be 9 months so I want to see what position the talus is in, in order that I can show it to the osteopath if my suspicion is correct.

Best views for radiographs?

Thanks

Robin

 

Have you spoken to the Osteo? It may be a simple typo, of it may be a case of a clash in terminology.
I don't think that a radiograph would necessarily show anything either way unless... What are the patients symptoms? Forced dorsiflexion injury and 'posterior talus' sounds like a recipe for posterior impingement syndrome...