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Dynamic supination during swing phase of gait
2%
32/2088
Limited push-off power, limited forefoot contact, and excessive heel contact during stance phase of gait
14%
289/2088
Recurrent ankle sprains
55%
1143/2088
Posterior tibial tendon insufficiency
26%
552/2088
Weak tibialis anterior relative to the peroneus longus resulting in first ray plantar flexion
51/2088
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Recurrent ankle sprains may be associated with tarsal coalition between the talus, the calcaneus, and/or the navicular. Calcaneonavicular coalitions are most common in children aged 8 to 12 years and talocalcaneal coalitions are most common in the 12 to 15 year age group. 10% to 20% of patients with tarsal coalitions have two coalitions and 50% are bilateral. Tarsal coalitions are often asymptomatic, and can present in late childhood or adolescence due to stresses transferred from the rigid hindfoot. Patients with tarsal coalition often exhibit a rigid flatfoot as shown in Figures A and B. Kumar et al present Level 4 evidence describing the 3 types of fusion (fibrous, cartilaginous, or osseous) and note that in 18 cases surgical resection of the coalition had good or excellent results in all but 2 feet. Churchill et al report in their Level 5 review that plain radiographs, as shown in Figures C and D, may demonstrate talar beaking or the “anteater nose” sign in the distal calcaneus. CT scans, as shown in Illustration A and B, can be helpful adjuncts for identification and delineation, particularly talocalcaneal coalitions.
3.3
(35)
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