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Sustentaculum Tali Palpation, Fracture, X-ray, CT-Scan, Anatomy

Sustentaculum Tali is a small supporting bone present in the heel of every person. It is derived from a Latin word i.e. sustenus which means support and Tali is referred as talus bone present in body. It is present as a shaft which originates from the anteromedial portion of calcaneus or heel bone. The Tali bone is bowel shaped from its superior side. Tali bone is directly in contact with middle calcaneal surface of talus. The inner side of Tali gives space to attachment of a tendon named flexor hallucis longus. Talar shelf is another name of this above described structure.



Sustentaculum Tali Palpation


Palpation is a diagnostic procedure in which physician check the severity and location of disease in patient's body by touching it externally. To check problem in sustentaculum Tali, physician would allow patient to sit on the examination table. Patient is asked to dangle down his legs from knees (90 degrees flexon). There should be no weight on feet. Now physician will sit right in front of patient and start palpating his foot with his finger tips. He'll ask patient to tell if he feels any pain on touching sustentaculum Tali. If patient feels pain, then right and left sided feet are compared.

Sustentaculum Tali Palpation, Fracture, X-ray, CT-Scan, Anatomy

Sustentaculum Tali Fracture


Sustentaculum Tali may get fracture due to any trauma or injury. It is a serious case and direct medical approach is recommended. If the fracture is the depression in medial facet, then these can be repaired. There are two main types of fracture of sustentaculum Tali i.e. intra articular fracture and extra articular fracture. Both fractures involve different parts of bone. In intra articular fracture, calcaneo cuboid joints and the subtalar joints are involved whereas in extra articular fracture, the subtalar joints and calcaneo cuboid joints are not involved.

Sustentaculum Tali Anatomy


There are many ligaments and tendons are associated with talar shelf or sustentaculum Tali. The three main ligaments are as follows:


  • Medial talocalcaneal ligament.
  • Plantar calcaneonavicular ligament which is attached to the anterior surface. 
  • Deltoid ligament attacher to the medial surface. 
  • Sustentaculum Tali is a console shaped protrusion which is attached to the middle surface of calcaneus. This attachment is from the upper side of sustentaculum Tali which we can also say a dorsal support. This structure corresponds to the mid calcaneal suface of the talus bone. It provides support to the talus bone. The lower part supports a tendon named flexor hallucis longi. 


Sustentaculum Tali X-Ray


Sustentaculum Tali is a supporting small bone which is essential for supporting talus bone. It can be seen easily via X-ray. If palpation indicate any pain or swelling, then physician recommend x-rays. In x-rays the fracture of sustentaculum Tali can be seen clearly.

Sustentaculum Tali CT Scan


If sustentaculum Tali fracture cannot be seen clearly in x-ray, then physician recommend computed tomography CT scan. In CT scan, the intra auricular and extra articular fracture can be seen clearly. In CT scan, the attached ligaments and tendons can also be seen clearly if got damage in fracture.
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