Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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PASSIVE TESTS OF THE SUBTALAR JOINT

Varus movement

Positioning.

The heel rests on the couch with the knee slightly flexed and the ankle in neutral
position. The examiner is distal to the foot and grasps the heel between the clasped hands. In order to avoid movements in the ankle joint the talus is stabilized between tibial and fibular malleoli. This is achieved by traction on the
heel and through a slight pressure with the trunk against the patient’s forefoot.

Procedure

Swing the upper half of the body inwards.

Common mistakes:

• Full dorsiflexion is lost.
• Uncomfortable pressure is exerted on the calcaneus.

Normallunctional anatomy:

• Rallge: 15–30·
• Elld-feel: ligamentous
• Limit;’lg structures:

– caleaneofibular ligament
– talocaleanean interosseus ligament
– joint capsule
– posterior fibres of the deltoid ligament.

Common pathological situations:

• A progressive limitation of varus indicates a capsular lesion of the subtalar joint. In significant arlhritis varus is completely lost by a spasm of the peronei.
• Lateral pain at full range may be indicative of a sprain of the caleaneofibular ligament.

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