Sinus tarsi

The sinus tarsi, also known as the talocalcaneal sulcus,[1] is a cylindrical canal in the hindfoot. It has a complex anatomy, with five ligamentous structures and a pad of adipose tissue (fat).[2] The tarsal canal opens up into the sinus tarsi,[3] however, the tarsal canal is a distinct structure.

Sinus tarsi
A labeled diagram of the foot bones, with the sinus tarsi labeled (upper right; next to Tarsus label)
SynonymsTalocalcaneal sulcus
Identifiers
TA98A02.5.11.009
TA21476
FMA35138
Anatomical terminology

Structure

The sinus tarsi located in the hindfoot, it is contained by the calcaneus, talus, talocalcaneonavicular joint, and the bottom of the subtalar joint.[1] There are five ligamentous structures present inside it: the intermediate, medial, and lateral roots of the inferior extensor retinaculum; the cervical ligament, and the interosseous talocalcaneal ligament. There is also a pad of adipose tissue.[2] The tarsal canal also opens up into the sinus tarsi.[3]

Physiology

The sinus tarsi helps stabilize the ankle, as the cervical ligament limits inversion of the (turning in) and the interosseous talocalcaneal ligament limits eversion (turning out).[2]

Clinical significance

Prior to the discovery of sinus tarsi syndrome, the sinus tarsi was not well studied and was seen as irrelevant.[4]

Sinus tarsi syndrome

Sinus tarsi syndrome is a clinical disorder of pain and tenderness in the sinus tarsi. This disorder can have a variety of causes; however, the most common is an inversion ankle sprain.[5]

Surgery access

In recent years, approaching a displaced intra-articular calcaneus fracture via the sinus tarsi during surgery has been found to be more efficient in reconstructing the bone and less invasive, preserving soft tissue around the bone.[6][7]

References
  1. Tu, P (January 2018). "Heel Pain: Diagnosis and Management". American Family Physician. 97 (2): 86–93. ISSN 1532-0650. PMID 29365222.
  2. Arshad, Z; Bhatia, M (August 2021). "Current concepts in sinus tarsi syndrome: A scoping review". Foot and Ankle Surgery. 27 (6): 615–21. doi:10.1016/j.fas.2020.08.013. ISSN 1460-9584. PMID 32978087. S2CID 221937877.
  3. Pisani, G; Pisani, PC; Parino, E (January 2005). "Sinus tarsi syndrome and subtalar joint instability". Clinics in Podiatric Medicine and Surgery. 22 (1): 63–77. doi:10.1016/j.cpm.2004.08.005. PMID 15555844.
  4. Brown, Joseph Edmund M.D. (1960). "The Sinus Tarsi Syndrome". Clinical Orthopaedics. 18: 231–233.
  5. Bouché, Richard. "Sinus Tarsi Syndrome". American Academy of Podiatric Sports Medicine. Retrieved 2022-12-22.
  6. Khazen, G; Rassi, CK (December 2020). "Sinus Tarsi Approach for Calcaneal Fractures". Foot and Ankle Clinics. 25 (4): 667–81. doi:10.1016/j.fcl.2020.08.003. PMID 33543722. S2CID 225001642.
  7. Weinraub, GM; David, MS (April 2019). "Sinus Tarsi Approach with Subcutaneously Delivered Plate Fixation for Displaced Intra-Articular Calcaneal Fractures". Clinics in Podiatric Medicine and Surgery. 36 (2): 225–31. doi:10.1016/j.cpm.2018.10.005. PMID 30784533. S2CID 73496271.
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