Variations of the Posterolateral Tubercle of the Talus: Geometric Analysis, Angular Safe Zones, and Implications for Talar Fixation Using a Three-Dimensional Simulation Model

Authors

  • Orrawan Srinark Department of Anatomy and Unit of Human Bone Warehouse for Research, Faculty of Medicine, Khon Kaen University, Thailand
  • Rarinthorn Samrid Department of Anatomy and Unit of Human Bone Warehouse for Research, Faculty of Medicine, Khon Kaen University, Thailand
  • Arada Chaiyamoon Enter the full name of the institution below, avoiding any acronyms. Select the name from the dropdown and click "Add" to include the affiliation in your profile (e.g. "Simon Fraser University")
  • Nichapa Phunchago Enter the full name of the institution below, avoiding any acronyms. Select the name from the dropdown and click "Add" to include the affiliation in your profile (e.g. "Simon Fraser University")
  • Chanasorn Poodendaen Department of Anatomy, Faculty of Medical Science, Naresuan University, Thailand
  • Suthat Duangchit Department of Physiology, Faculty of Medical Science, Naresuan University, Thailand
  • Sitthichai Iamsaard Department of Anatomy and Unit of Human Bone Warehouse for Research, Faculty of Medicine, Khon Kaen University, Thailand

DOI:

https://doi.org/10.5644/ama2006-124.522

Keywords:

Talus, Posterolateral Tubercle, Talar Screw Fixation, Simulation Model, Northeastern Thai Skeletal Collection

Abstract

Objective. To investigate the prevalence of posterolateral tubercle variants and characterize the simulated safe zones and screw insertion angles for posterior-to-anterior talar screw fixation using individual 3D models from a Northeastern Thai skeletal collection.

Materials and Methods. A total of 1,106 dry tali from 553 skeletons (301 males and 252 females), aged 22–106 years, were classified according to posterolateral tubercle type. Safe zones for posterior-to-anterior (PA) screw fixation were determined for the left and right tali in both sexes using 3D simulation models, and the widest possible screw insertion angles were simulated.

Results. The posterolateral tubercle was classified into three types: Type 1 (almost absent, 1.36%), Type 2 (normal, 45.48%), and Type 3 (enlarged, 53.16%). In selected individual male talus models, the illustrated safe-zone configurations ranged from 20% to 50% on the left and from 30% to 60% on the right. In selected individual female talus models, the illustrated safe-zone configurations ranged from 20% to 70% on the left and from 20% to 50% on the right.

Conclusion. The enlarged posterolateral tubercle was the most prevalent variant in the Northeastern Thai skeletal sample. The selected individual models illustrated differences in simulated safe-zone configurations and insertion angles according to side and sex. These findings may provide anatomical reference information for preoperative planning of screw fixation involving the posterolateral region of the talus.

References

Saravi B, Lang G, Ruff R, Schmal H, Südkamp N, Ülkümen S, et al. Conservative and Surgical Treatment of Talar Fractures: A Systematic Review and Meta-Analysis on Clinical Outcomes and Complications. Int J Environ Res Public Health. 2021;18(16):8274. doi: 10.3390/ijerph18168274.

Roberts LE, Pinto M, Staggers JR, Godoy-Santos A, Shah A, de Cesar Netto C. Soft tissue structures at risk with percutaneous posterior to anterior screw fixation of the talar neck. Foot Ankle Int. 2018;39(10):1237-41. doi: 10.1177/1071100718777771.

Sanders DW, Busam M, Hattwick E, Edwards JR, McAndrew MP, Johnson KD. Functional outcomes following displaced talar neck fractures. J Orthop Trauma. 2004;18(5):265-70. doi: 10.1097/00005131-200405000-00001.

Hawkins LG. Fractures of the neck of the talus. J Bone Joint Surg Am. 1970 Jul;52(5):991-1002. PMID: 5479485.

Vallier HA, Nork SE, Barei DP, Benirschke SK, Sangeorzan BJ. Talar neck fractures: results and outcomes. J Bone Joint Surg Am. 2004;86(8):1616-24. PMID: 15292407.

Lemaire RG, Bustin W. Screw fixation of fractures of the neck of the talus using a posterior approach. J Trauma. 1980;20(8):669-73. doi: 10.1097/00005373-198008000-00006.

Mulfinger GL, Trueta J. The blood supply of the talus. J Bone Joint Surg Br. 1970;52(1):160-7. PMID: 5436202. 8. Fortin PT, Balazsy JE. Talus fractures: evaluation and treatment. J Am Acad Orthop Surg. 2001;9(2):114-27. doi: 10.5435/00124635-200103000-00005.

Abdelkafy A, Imam MA, Sokkar S, Hirschmann M. Antegraderetrograde opposing lag screws for internal fixation of simple displaced talar neck fractures. J Foot Ankle Surg. 2015;54(1):23-8. doi: 10.1053/j.jfas.2014.09.046. Epub 2014 Nov 1.

Lindvall E, Haidukewych G, DiPasquale T, Herscovici D Jr, Sanders R. Open reduction and stable fixation of isolated, displaced talar neck and body fractures. J Bone Joint Surg Am. 2004;86(10):2229-34. doi:

10.2106/00004623-200410000-00014.

Wu JQ, Ma SH, Liu S, Qin CH, Jin D, Yu B. Safe Zone of Posterior Screw Insertion for Talar Neck Fractures on 3-Dimensional Reconstruction Model. Orthop Surg. 2017;9(1):28-33. doi: 10.1111/os.12303.

Shin DE, Yoon HK, Choi WJ, Lee YS, Han SC. Screw Fixation Techniques for Talar Neck Fractures (Anterior versus Posterior insertion). J Korean Foot Ankle Soc. 2010;14(1):79-83.

Kalbouneh H, Alsalem M, Bani-Hani M, Alhusamiah H, Momani Y, Massad T, et al. A Comprehensive Study of the Anatomical Variations of the Posterolateral Tubercle of Talus. Int J Morphol. 2021;39(3):858-63. doi: 10.4067/S0717-95022021000300858.

Mao H, Wang H, Wang L, Yao L. Definition of a safe zone for screw fixation of posterior talar process fracture by 3-dimensional technology. Medicine (Baltimore). 2018;97(49):e13331. doi: 10.1097/MD.0000000000013331.

Fan Z, Ma J, Chen J, Yang B, Wang Y, Bai H, et al. Biomechanical efficacy of four different dual screws fixations in treatment of talus neck fracture: a three-dimensional finite element analysis. J Orthop Surg Res. 2020;15(1):45. doi: 10.1186/s13018-020-1560-8.

Ebraheim NA, Mekhail AO, Salpietro BJ, Mermer MJ, Jackson WT. Talar neck fractures: anatomic considerations for posterior screw application. Foot Ankle Int. 1996;17(9):541-7. doi: 10.1177/107110079601700906.

Gogtay NJ. Principles of sample size calculation. Indian J Ophthalmol. 2010;58(6):517-8. doi: 10.4103/0301-4738.71692.

He JQ, Ma XL, Zhang X, Xin JY, Li N. Three-dimensional computer-assisted modeling of talus morphology in Chinese patients. Orthop Surg. 2016;8(3):383-92. doi: 10.1111/os.12258.

Zwiers R, Baltes TPA, Opdam KTM, Wiegerinck JI, van Dijk CN. Prevalence of Os Trigonum on CT Imaging. Foot Ankle Int. 2018;39(3):338-42. doi: 10.1177/1071100717740937.

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Published

27.10.2026

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Clinical Science

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How to Cite

Variations of the Posterolateral Tubercle of the Talus: Geometric Analysis, Angular Safe Zones, and Implications for Talar Fixation Using a Three-Dimensional Simulation Model. (2026). Acta Medica Academica. https://doi.org/10.5644/ama2006-124.522

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