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.

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.

Background & Objective: To assess the effect of a lateral–wedge insole with Subtalar supporting on the femorotibial angle in patients with varus defomrity of the knee.Materials & Methods: The efficacy of a wedged insole with Subtalar supporting and that of traditional wedge insole shoe insert were compared. 20 outpatients with knee osteoarthritist were randomized to be treated with either the supported or traditional inserted insole. In group, the baseline and 2 month koos scores for subjective knee pain and ADL and quality of live and symptoms were compared.Results: At the baseline, there were no significant difference in the femorotibial angle and pain and ADL, quality of life and symptoms, the 10 subjects wearing the Subtalar supporting demonstrated a significatly increase femoretibial angle and koos scores without pain compared with insole group, there were no significant difference between twe group in pain after treatment.Conclusion: These results suggest that an insole with a Subtalar supporting maintained the valgus correction of the, femoretibial angle in patgle in patients with varus knee OA for 2 months.

Tibialis posterior muscle dysfunction leading to adult acquired flatfoot deformity. Tibialis posterior muscledysfunction is commonly treated with a flexor digitorum longus tendon transfer to the tubercle of navicularbone. In recent years, the dynamic computer modeling has been used to predict the results of surgical andtreatment. The aim of this study was to provide a dynamic computer model of flexor digitorum longus tendontransfer for predicting the outcome of flat foot treatment. In this study the 3D model of ankle Joint, whichconsists of 29 bones and 12 muscles was developed in OpenSim. Using software, ankle plantar flexion moment,metatarsophalangeal Joints moment and inversion moment of Subtalar Joint were drawn. After flexor digitorumlongus tendon transfer, there were decreases ankle plantar flexion moment (6.7%), metatarsophalangeal Jointsmoment (45%) and inversion moment of Subtalar Joint (34%). Plantar flexion moment reduction caused nosignificant changes in the ankle Joint, but reduction in metatarsophalangeal Joints could limit heel lift duringpropulsive phase in walking or running. A decreased inversion moment at the Subtalar Joint could alter thebiomechanics of lower extremities.

Transcalcaneal talonavicular fracture dislocation is an extremely rare debilitating injury with high complication rates. The present case report demonstrates highly comminuted Joint-depressed fracture of left calcaneus treated with primary Subtalar arthrodesis following reduction and fixation of the calcaneus. The right ankle sustained a highly comminuted fracture of calcaneal body with completely-destroyed posterior facet, fracture dislocation of the calcaneocuboid Joint, dorsally dislocated talonavicular Joint, fracture of anterior of tibial plafond, and subluxation of the tibiotalar Joint. At first, talonavicular Joint was reduced and fixed using a plate followed by reduction of calcaneus and arthrodesis of Subtalar and calcaneocuboid Joints. The plate of talonavicular Joint was removed after 70 days. Logical approach to this injury can lead to an acceptable function.

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.

Alarm systems are essential in safe operation of industrial plants. Since many process variables are interacting with each other, so in this paper, an approximate method is introduced to design and analysis of a multivariate alarm system. In this method, the alarm system is designed base on Joint indices. The Joint FAR and Joint MAR are defined for a m-variable alarm system thanks to multivariate Markov scheme. In proposed method, the alarm Joint indices are defined by solving a Linear Programing (LP) optimization problem. By defining Joint indices, tuning of the alarm parameters (like, threshold and etc. ) can be done by these indices instead of correlation analysis. In this paper, penalty scenario and Genetic algorithm are used for alarm generation, and parameter optimization in Tennessee Eastman (TE) Process. The results of proposed method are compared with other methods.

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.

Tarsal coalition is an often unrecognised cause of foot and ankle pain and represents a congenital osseous, cartilaginous or fibrous connection between two or more tarsal bones. Fractures in combination with tarsal coalitions are rarely described in the literature. We report the case of a 43-year-old male patient with a talocalcaneal coalition who sustained an open comminuted calcaneal fracture and a closed transverse cuboid fracture. Due to the asymptomatic tarsal coalition and the already firmly fixed Subtalar Joint, the patient was treated with open reduction and internal fixation (ORIF) with satisfactory outcomes instead of ORIF in combination with Subtalar arthrodesis. Ten months after the trauma, the patient was satisfactory and could return to his regular work. There is currently no evidence for the gold standard treatment of calcaneal fractures with combined tarsal coalitions. Due to the satisfactory results of this case, authors conclude that in case with prior asymptomatic coalitions, singular ORIF without Subtalar arthrodesis may be performed.

Background and Aims: Footwears are routinely used with the belief that they have a direct effect on the knee. Excessive pronation of the Subtalar Joint with associated internal rotation of the tibia relative to the femur has been postulated to be a causative factor of patellofemoral pain syndrome (PFPS). Motion control shoes aim to reduce excessive rearfoot motion and lead to reduction of internal rotation of tibia. The aim of the present study was to evaluate the effect of motion control shoes on the three dimensional lower limb Joint moments during running in patellofemoral pain syndrome females. Materials and Methods: A total of 20 females with PFPS performed 5 running trials at 3 ± 0. 2 m/s speed. Two shoes were tested: the Nike free 5 shoe (control)، and the Asics GEL-Kayano 21 (motion control). Joint moments calculation was carried out using invers dynamic equations. Also, betweencondition comparisons were assessed running paired T-test (P≤ 0. 05). Results: A motion control shoe significantly reduced peak ankle adductor moment (p=0. 038)، increased external rotator (p=0. 001), and decreased abductor knee Joint moments (p=0. 024). In the hip Joint، adductor moment was decreased (p=0. 005) and the external rotator moment was increased (p=0. 001) using motion control shoe. No differences were observed in sagittal plane lower limb Joint moments between the two shoes. Conclusion: The results of our study indicated that a motion control shoe can control the Subtalar Joint pronation by decreasing the amount of adductor moment and increasing peak of the inversion angle during running. The effectiveness of these shoes in frontal and horizontal planes is high as they seem to control the rearfoot movement in these planes. These results indicate that the motion control shoes as an efficient and nonsurgical prevention must be considered for PFPS.