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Classification of the subtalar articular surface and its matching situation: an anatomical study on Chinese subtalar joint

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Abstract

Purpose

The subtalar joint (STJ) is complex in anatomy and function. The purpose of this study is to classify the articular surface of the calcaneus in a sample Chinese population and discuss the relationship between its matching situation and the stability of STJ.

Methods

328 patients with 445 STJs were measured and classified using CT three-dimensional reconstruction. The calcaneal facets were classified according to the morphological characteristics. According to the number, shape, and fusion of the calcaneus and talus facets, the matching situation was determined. The parameters of measurement: the Gissane’s angle, the Böhler’s angle, the long-axis sum and the short-axis sum, and the average total joint facet area.

Results

The calcaneal surfaces in a sample Chinese population were classified into five types: Type I (219, 49.2%), Type II (102, 22.9%), Type III (68, 15.3%), Type IV (47, 10.6%) and Type V (9, 2%). The total matching rate of STJ is 98%. In terms of Gissane’s angle, there was a significant difference between Type II and Type IV (P < 0.05). The long-axis sum of Type III (4.53 ± 0.58 cm) was significantly smaller than other types (P < 0.05). Type II (3.64 ± 0.47 cm) was statistically larger than other types in the short-axis sum (P < 0.05). The average total joint facet area of Type III (7.05 ± 1.40 cm2) was significantly smaller than other types (P < 0.05). Type V (9.31 ± 3.96 cm2) was statistical differences with Type II, Type III and Type IV (P < 0.05). There was no statistically significant difference between left and right sides of the articular facets in this study (P > 0.05).

Conclusions

According to Bunnins’s classification, the type with separated facets predominated but the matching situation between STJ was not elaborated, which was closely linked to the stability of STJ and surgical strategy of calcaneus fracture. The calcaneus articular surfaces in a sample Chinese population were divided into five types. Type I was the most common type and Type V was the rarest. Type II have the highest stability, Type V may be the lowest stability and Type III was more prone to osteoarthritis. The STJ articular surfaces were basically matched, contributing to the coordinate movement of the STJ. The matching articular surfaces of STJ were more stable than the mismatching surfaces. To some extent that STJ facet number, shape, facet area, and matching situation are factors in STJ stability, and the anatomical variations of the STJ offer predictive value in determining the predisposition to STI.

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Funding

This study was supported by the Academician Workstation in Luzhou (20180101) and Luzhou Municipal Government—Southwest Medical University Shizhen Zhong Academician Talent Team Subproject (2018zszysrctdxm).

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Author notes

  1. Badalahu, Bo Qin, Jiangqin Luo, Yan Zeng, and Shijie Fu contributed equally to this work.

Authors and Affiliations

  1. Affiliated Hospital of Inner Mongolia University for the Nationalities, Inner Mongolia Autonomous Region, Tongliao, China

    Badalahu

  2. Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China

    Bo Qin, Jiangqin Luo, Yan Zeng, Shijie Fu & Lei Zhang

  3. Center for Orthopedic Diseases Research, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, Sichuan, China

    Bo Qin, Shijie Fu & Lei Zhang

  4. Academician Workstation in Luzhou, Luzhou, Sichuan, China

    Bo Qin, Shijie Fu & Lei Zhang

  5. Clinical Base of Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Guangdong Province Medical 3D Printing Application Transformation Engineering Technology Research Center, Luzhou, Sichuan, China

    Bo Qin, Shijie Fu & Lei Zhang

  6. National Key Discipline of Human Anatomy, School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong, China

    Lei Zhang

Authors
  1. Badalahu
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  2. Bo Qin
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  3. Jiangqin Luo
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  4. Yan Zeng
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Contributions

LZ and Badalahu: conception and design, BQ: manuscript writing/editing, YZ: protocol/project development, JQ-L: data analysis, SJ-F: data collection. SJ-F: provision of materials and literature search.

Corresponding author

Correspondence to Lei Zhang.

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There was no conflict of interest with the submission of this manuscript, and the manuscript was approved by all authors for publication.

Ethical approval

Ethical approval was given by the medical ethics committee of Southwest Medical University with the following reference number: KY2018012.

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Badalahu, Qin, B., Luo, J. et al. Classification of the subtalar articular surface and its matching situation: an anatomical study on Chinese subtalar joint. Surg Radiol Anat 42, 1133–1139 (2020). https://doi.org/10.1007/s00276-020-02444-4

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  • DOI: https://doi.org/10.1007/s00276-020-02444-4

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