Description
This transcript represents a comprehensive presentation given by Andrew Goldberg on the subtalar joint and its functionality within the context of foot stability and mobility, as part of an online medical congress hosted by the British Orthopaedic Foot & Ankle Society (BOFAS). Goldberg discusses the intricacies of the subtalar joint, referring to its functionality, anatomy, and the complexities involved in diagnosing and treating subtalar instability. He highlights the misconception surrounding subtalar movements, arguing that terms like eversion, abduction, and dorsiflexion oversimplify the joint's operational mechanics. He elaborates on a collaborative research study, conducted to determine the center of rotation of the subtalar joint, ultimately claiming that it lies through the middle facet, countering previous notions that it was the lateral facet.
The address transitions into clinical relevance, where Goldberg emphasizes the importance of recognizing chronic ankle instability as often intertwined with subtalar instability. He shares insights on surgical procedures, particularly the Brostrom procedure, which addresses ligament tears but highlights potential surgical pitfalls when the calcaneofibular ligament (CFL) is injured or misjudged during repair. Importantly, he advocates for the evaluation of the peroneal tendons in conjunction with evaluating subtalar joint stability, demonstrating how chronic instability can lead to peroneal tendon damage.
The presentation concludes with a Q&A segment discussing the nuances of surgical approaches and determining preoperative evaluation methods for subtalar instability, emphasizing advancements in MRI imaging techniques and the challenges in providing definitive clinical assessments.