The talar head is the anterior rounded portion of the talus that articulates with the navicular bone anteriorly at the talonavicular joint, and with the anterior and middle calcaneal facets inferiorly as the anterior part of the subtalar joint complex. The plantar calcaneonavicular (spring) ligament spans the inferior aspect of the talar head, providing the primary support structure beneath it. The tibialis posterior tendon wraps around the medial ankle to insert adjacent to the talar head.
The talar head prominence on the medial foot is one of the hallmarks of adult acquired flatfoot deformity: as the spring ligament and tibialis posterior tendon fail, the head of the talus plantar flexes and abducts, becoming visible and palpable as a bony prominence on the medial midfoot. Talar head coverage by the navicular is assessed on AP weight-bearing radiograph: normal is greater than 75% coverage; uncoverage indicates progressive deformity. Talar head fractures occur in high-energy axial compression (Hawkins classification includes head fractures as Type IV).
Progressive spring ligament and TPT failure allows the talar head to plantar flex and adduct medially, with decreasing talonavicular coverage angle on AP weight-bearing radiograph; medial column fusion and calcaneal osteotomy restore talar head coverage and correct the hindfoot valgus deformity.
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