Bilateral Multiple Tarsal Coalitions (Talonavicular and Talocalcaneal Coalitions) with Recurrent Ankle Sprain in an Adolescent

Tarsal coalition is defined as an abnormal bony, cartilaginous, or fibrous union of two or more tarsal bones. The incidence of tarsal coalition is approximately 2% in the general population. Talocalcaneal and calcaneonavicular coalitions are the most common. The talonavicular coalition is a rare entity with an incidence of approximately 1.3% among patients with tarsal coalitions. We present a case of a 12-year-old girl who had talonavicular and talocalcaneal coalitions associated with a recurrent ankle sprain. The talonavicular coalition was asymptomatic, and the talocalcaneal coalition was the cause of ankle pain and recurrent sprain. Surgical resection of the talocalcaneal coalition led to successful clinical and functional outcomes. In conclusion, the possibility of multiple tarsal coalitions should be considered in tarsal coalition patients, and the talocalcaneal coalition should be considered as a differential diagnosis in an adolescent patient with a recurrent ankle sprain.

Individuals with Recurrent Ankle Sprain Demonstrate Postural Instability and Neuromuscular Control Deficits in Unaffected Side

Category: Ankle, Sports Introduction/Purpose: To compare proprioception, postural stability, and neuromuscular control between patients with mechanical laxity and recurrent ankle sprain. Methods: Among 86 patients with ankle instability, 45 patients had mechanical laxity (mean age 27.2 ± 7.0 years) and 41 had recurrent ankle sprain (mean age 25.1 ± 9.2 years). Both the affected and unaffected ankles of each patient were evalu- ated. Proprioception and neuromuscular control tests were conducted using an isokinetic machine, and postural stability was tested using a postural stabilometry system. Results: Proprioception was not significantly different between the unaffected or affected ankles of the mechanical laxity group compared with those of the recurrent ankle sprain group (n.s). Static and dynamic postural stability and neuromus- cular control were similar in the affected ankles between the two groups (n.s). However, postural stability (static, overall: p = 0.009, anterior– posterior: p = 0.028, medial–lateral: p = 0.022; dynamic, overall: p = 0.012, anterior–posterior: p = 0.004, medial–lateral: p = 0.001) and neuromuscular control (inversion: p = 0.031, eversion: p = 0.039, dorsiflexion: p = 0.029, plantarflexion: p = 0.035) were significantly decreased in the unaffected ankles of the recurrent ankle sprain group compared with those of the mechanical laxity group. Conclusion: The unaffected ankles of the recurrent ankle sprain group showed significant decreases in both postural stability and neuromuscular control compared with the mechanical laxity group. Clinicians and therapists should consider unaffected ankle rehabilitation in patients with recurrent ankle sprain to prevent future sprain events.