The subtalar joint controls inversion and eversion of the hindfoot and is the joint that allows the foot to adapt to uneven terrain. Its coupled motion with the transverse tarsal joint (talonavicular and calcaneocuboid) produces the pronation and supination movements essential for normal gait. Subtalar arthritis and coalitions are important causes of hindfoot stiffness and pain that significantly affect gait and function.
Subtalar arthritis following calcaneal fractures or inflammatory arthropathy produces hindfoot stiffness and pain on uneven ground that is confirmed by limited inversion and eversion with pain at the subtalar joint line, a distinct location from the ankle joint above. Subtalar coalition (congenital fusion between the talus and calcaneus) presents in adolescence with a peroneal spastic flatfoot and rigid hindfoot that are confirmed on CT. Subtalar fusion is performed for both arthritis and painful coalition.
Degeneration of the subtalar articular surfaces producing hindfoot stiffness and pain on uneven terrain, most commonly following calcaneal fractures, confirmed by limited hindfoot motion and CT or MRI findings.
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