SUBTALAR dislocation is the simultaneous dislocation of the distal articulations of the talus at both the talocalcaneal and talonavicular joints. It can occur in any direction and always produce significant deformity. Most common is the medial dislocation (80% of cases). Less common presentations are lateral (20% of cases), anterior and posterior dislocations. These dislocations are associated with osteochondral fractures. Closed reduction and immobilisation remains the mainstay of treatment. Proper radiographs and CT scan confirms the post reduction alignment stability of SUBTALAR joints and intraarticular fracture fragments. We report a case of medial SUBTALAR dislocation with no osteochondral fracture fragments in a 17-year-old young man.

Background: osteotomy around the knee is one of the most common corrective surgeries for lower limb deformities. The exact relationship between the effects of these surgeries on the ankle joint is unclear. This study aimed to investigate the effect of HTO on the SUBTALAR joint in patients with genu varum. Methods: In the case series study33 patients including 27. 2% men and 72. 7% womenwith an average age of 41. 9, with genu varum who underwent corrective surgery of open wedge high tibial osteotomy were studied. the heel alignment angle was determined before and after surgery in 10-months follow-up based on Saltzman view in conventional radiography. The data were then compared. Results: Average genu varum correction angle was 11. 9± 1. 3 ° . Heel alignment degree was 5. 9± 1. 3 ° before HTO surgery, and after the surgery, in final follow-up, it was to 3. 4± 1. 2 ° valgus, this value was statisticallysignificant(p=0. 04). Moreover, there was a significant statistical relationship between average correction of Varus deformity and heel alignment anglechanges (P=0. 02, r=0. 3). Conclusion: Correcting Varus knee deformity can be effectiveon heel alignment angle in patients undergoing HTO surgery with genu varum. The angle of the SUBTALAR valgus decreases as a result.

Background: Lateral wedge insole (LWI) aims to reduce loading on medial compartment of tibiofemoral joint in mild knee osteoarthritis (KOA). This effect may be augmented by concomitant use of SUBTALAR strap to fix the ankle joint. Moreover, longitudinal arch support embedded in insoles can cause foot comfort and may be beneficial for people with KOA. Therefore, this study aimed to assess the immediate effect of LWI with an arch support with and without a SUBTALAR strap on the kinetics and kinematics of walking in mild KOA. Methods: A convenient sample of 17 individuals with mild KOA (Kellgren and Lawrence grade II), aged ≥ 40 years were assessed in 3 conditions: without the insole; LWI; and LWI with a SUBTALAR strap, where an arch support was embedded in all insoles. The primary outcomes were external knee adduction moment and angular impulse. The secondary outcomes were hip flexion and adduction moments, knee flexion angle, ankle eversion moment, and walking speed. The repeated measurements ANOVA was used to compare the primary and secondary outcomes between the conditions using SPSS. Significance level was set at 0. 05. Results: LWI and a SUBTALAR strap can significantly increase the knee flexion angle at 0%-15% of the stance phase compared to no insole (p<0. 001). No other changes were observed (p=0. 142). Conclusion: LWI with an arch, with or without a SUBTALAR strap, cannot impose any immediate changes on the kinetics and kinematics of lower limb joints during walking in people with mild KOA.

Background: The calcaneofibular ligament is cut to increase vision in surgical field in minimally invasive surgery of displaced intraarticular calcaneus fractures with SUBTALAR incision. We aimed to investigate whether this causes talar tilt instability in ankle stress radiographs due to the calcaneofibular ligament deficiency in postoperative period. Methods: The files of 38 patients who were operated with the diagnosis of displaced calcaneus fracture between 2013 and 2018 were examined retrospectively. All the cases underwent with SUBTALAR approach and the calcaneofibular ligament was repaired after the operation. The age, sex, injury mechanism, follow-up length, type of fracture by the Sanders classification, preoperative and postoperative Bohler’ s and Gissane’ s angle measurements, talar tilt measurements of intact and fractured side, postoperative calcaneal length, calcaneal height and calcaneal width of the cases were recorded. The obtained data were evaluated statistically. Results: 31 (81. 6%) of the cases were men, seven (18. 4%) were women. The average age was 31. 92± 7. 95 years. The average follow-up time was 15. 82± 3. 33 months. The preoperative Bohler’ s angle was 14. 16± 3. 67 degree, while the postoperative Bohler’ s angle was 31. 53± 4. 60 degree (P<0. 05). The average talar tilt was 0. 96± 0. 87 degrees on the intact side and 1. 19± 1. 12 degrees on the fractured side (P: 0. 001). Although the talar tilt values were statistically higher on the fractured side than the intact side, no radiological instability finding was found in any case. The average postoperative Gissane’ s angles were 126. 45± 6. 69 degrees. The calcaneal length (P: 0. 665), calcaneal width (P: 0. 212) and calcaneal height (P: 0. 341) were statistically similar between the postoperative fractured foot and intact foot. Conclusion: Sectioning of the calcaneofibular ligament in the surgical treatment with SUBTALAR approach does not cause lateral ankle instability in stress radiographs but may cause laxity. Possible postoperative lateral ankle injuries can be prevented by ankle proprioception exercises.

Introduction: In assessing the factors affecting the knee joint biomechanics, foot malalingments are more important due to ability to change the applied force direction. The main goal of this study was to investigate the relationship between the excessive SUBTALAR pronation, changes of Q-angle and whether taping of the medial longitudinal arch (MLA) could accordingly change these variables.Materials and methods: Seventy six volunteers (aged 20-40 years) were recruited from physical therapy clinic, rehabilitation school, Shiraz, Iran. They equally classified into 2 groups. They all agreed to sign the consent form. First group included thirty eight subjects with pronated symptomatic knees (PSK). They all reported knee pain symptom and had an excessive SUBTALAR pronation.The second group with thirty eight individuals reported no sign of knee pain and SUBTALAR excessive pronation (PASK). SUBTALAR and Q-angles were measured before and immediately after taping by a goniometer in both PSK and PASK groups.Pearson Correlation coefficient test, paired sample T-test and Wilcoxon test were used to analyze the data.Results: A strong correlation was found between SUBTALAR and Q-angles before taping in both PSK and PASK groups (In females; P=0.002 and P= 0.0010 for PSK and PASK, respectively and in males; P=0.001 and P =0.001 for PSK and PASK, respectively). There was a significant difference between SUBTALAR angle and Q-angles before and after applying taping method in both PSK and PASK.Conclusion: It seems that applying the MLA taping method may result in decreasing the Q- angle and eventually improve the knee joint biomechanics in subjects with foot over pronation.

Objective: The effects of lateral wedge insoles with and without SUBTALAR strap on vertical component of ground reaction force were compared.Methods: Twenty five patients aged over 40 years with grades I or II of medial compartment knee osteoarthritis based on Kellgrene and Lawrence grading system were participated in this study. They were tested in 3 conditions while walking in a 3-meter walkway: bare foot, lateral wedge insole and lateral wedge insole with SUBTALAR strap. Three successful trials were recorded in each condition. Gait analysis was performed to compare the immediate effect of lateral wedge insole with and without SUBTALAR strap on vertical component of ground reaction force.Results: There was significant effect of lateral wedge insole with SUBTALAR strap on second peak of vertical ground reaction force related to lateral wedge insole and without insole conditions. But no significant effect of lateral wedge insole with and without SUBTALAR strap was found on first peak of vertical ground reaction force and walking speed.Conclusion: The results of this study suggest that lateral wedge insole can reduce second peak of vertical ground reaction force. Also it was understood lateral wedge insole with SUBTALAR strap might be more efficacious than lateral wedge insole in mild knee osteoarthritis patients.