Title: Talus bone of the hindfoot: Unique anatomy and an important clinical implication
Abstract:
Talus is a pivotal bone that aids in easy and correct locomotion and transfers body weight from the shin to the foot. Despite its small size, it is also involved in many clinical disorders. Reviewing and re-reading the anatomy of talus is absolutely essential for physicians and orthopaedic surgeons for proper diagnosis and management of any disorder. The talus is irregular bone located on top of the other bones of the foot, formed of head, neck and body. The neck bears a groove on its lower surface called the sulcus tali. In the articulated foot, it joins the sulcus below it, on the upper surface of the calcaneus, to form a tunnel called the sinus tali. The sinus lodges strong ligaments that connect the talus firmly with calcaneus, including interosseous and cervical talocalcaneal ligaments. Furthermore, the sinus holds an arterial anastomosis from which the main blood supply of talus arises. Therefore, a displaced neck fracture can lead to avascular necrosis of the bone. The talus has no muscle attachment. However, it does have many ligaments attached to it and others around it to keep it in place. Moreover, the bone plays a pig role in movements due to its involvement in many joints. Most of its surface is covered by articular cartilage. Therefore, its blood supply is relatively poor. This puts the talus at greater risk for poor healing as well as more complications in the event of injury than any other bone. Moreover, the talus has significant anatomical variations that must be identified to rule out confusion in clinical practice and malpractice and to ensure appropriate diagnosis and management. These variations include talocalcaneal coalition and accessory ossicles such as os trigonum. Congenital talar abnormalities must also be carefully recognized as they can lead to pain and functional impairment in the foot. This includes congenital vertical ankles as well as congenital flatfoot due to congenital medial and plantar deviations in the talar head. We hope this makes it easier for clinicians to follow and understand the updated essential knowledge of one of the most complex bone anatomies that they need in their clinical practice.
