Abnormal STJ Motion

Question 1

What is the normal STJ axis?

Answer 1

42 deg from transverse plane
16 deg from sagittal
(48 from frontal plane)

Question 2

what motion occurs around the STJ axis?

Answer 2

equal frontal (inversion/eversion) and transverse motion (abduction/adduction)

Question 3

what is STJ pitch? what is normal STJ pitch?

Answer 3

(normal is 35-45 deg) the location of STJ from transverse plane

Question 4

the more vertical the STJ axis, the more motion occurs around which plane?

Answer 4

(horizontal/transverse plane)

aka more abduction/adduction

Question 5

the more horizontal the STJ plane, the more motion occurs around which plane?

Answer 5

frontal plane

inversion/eversion

Question 6

a patient with a more vertical axis (high STJ pitch) will have what type of ROM?

Answer 6

more abduction/adduction

Question 7

a patient with a more horizontal axis (low STJ pitch) will have what type of ROM?

Answer 7

inversion/eversion

Question 8

a patient with high pitched STJ axis (>45 deg) will have what type of symptoms?

Answer 8

more medial knee pain than foot complaints

Question 9

a patient with low pitched STJ axis (<35 deg) will have what type of symptoms?

Answer 9

more foot than knee complaints

Question 10

a normal STJ axis runs thru which toe interspace?

Answer 10

1st intermetatarsal space

Question 11

a medially deviated STJ axis indicates what ?

Answer 11

STJ pronated

Question 12

a laterally deviated STJ axis indicates what?

Answer 12

STJ supination

Question 13

what is the most critical in the stance phase of gait?

Answer 13

position of the calcaneus

Question 14

what is calcaneal translational displacement?

Answer 14

a line that bisects the middle fo the calcaneus that lies almost always lateral to the tibio-talar bisection

Question 15

what is normal calcaneal translational displacement?

Answer 15

5-10mm lateral to tibio-talar bisection

Question 16

if the calcaneal translational displacement is >10mm lateral, then ground forces have what action on the heel?

Answer 16

causes heel to evert

Question 17

if the calcaneal translational displacement is >10mm medial, then ground forces have what action on the heel?

Answer 17

heel to invert

Question 18

what procedure would you use to correct flatfoot?

Answer 18

Koutsogiannis osteotomy

Question 19

describe the koutsogiannis osteotomy and what you would use it for.

Answer 19

(corrects flatfoot) by transposing the body of the calcaneus medially in order to create a supinatory moment of the STJ

Question 20

what procedure would you use to correct cavus foot?

Answer 20

Dwyer osteotomy

Question 21

describe Dwyer osteotomy and wha tyou would use it for.

Answer 21

(correct cavus foot)

• move the body of calcaneus more laterally in order to create a pronatory moment of the STJ
• is a closing wedge procedure performed by removing a wedge of bone on the lateral side of calcaneus

Question 22

what angle is used to measure the cavus foot?

Answer 22

calcaneal tibial angle

normal is 2 deg varus - 4 deg valgus