Surgical management of symptomatic talocalcaneal coalitions by resection of the sustentaculum
In the other model the calcaneus was fixated with the same AO calcaneal plate together with an additional screw being infiltrated into the sustentaculum
18) Absent visibility of the subtalar facets (usually middle subtalar facet) and a dysmorphic sustentaculum
tali are also helpful in diagnosing talocalcaneal coalition on a lateral x-ray of the foot, however the accuracy of these signs can be confounded by the direction of the x-ray beam.
A third line marks the border of the sustentaculum
The strongest portion of the superficial deltoid is the calcaneotibial ligament, which inserts at the sustentaculum
By doing so and by releasing the superficial part of deltoid ligament, by detaching the spring ligament from sustentaculum
tali and by dividing the talocalcaneal interosseous ligament and bifurcated ligament the navicular is completely mobilized and reduced onto the head of talus.
Together they glide over the sustentaculum
tali, joined distal to it by the tendon of the flexor pedis longus muscle.
Additional imaging findings, including marrow edema and fractures, and associated secondary signs, such as talar "beaks," the "anteater" (hyperplastic anterior calcaneal process) sign, and the innovative "reverse anteater" (hyperplastic navicular) and "drunken waiter" (hypo/dysplastic sustentaculum
tali) signs, were reported as well.
There was complete coalescence (bony fusion) between the sustentaculum
tali and the calcaneus (Fig.
The fibrosis of the above structure form a mass of indistinguishable scar, which obscures the midtarsal and subtalar joints, and maintain the tubersoity of the navicular and sustentaculum
tali in close proximity to the medial malleolus.
The superficial fibers arise from the anterior colliculus and the anterior aspect of the posterior colliculus, and they attach into the navicular, the neck of the talus, the medial border of the sustentaculum
tali, and the posteromedial talar tubercle.
tibialis posterior is supporting the medial arch, lifting up the inside of the talus head and bringing the navicular and sustentaculum
tali closer together, thereby taking tension off the plantar calcaneo-navicular ligament.