[Sinus tarsi and canalis tarsi syndromes. A post-traumatic entity]

The posttraumatic sinus tarsi syndrome is a clinical entity induced by supination trauma of the hindfoot. In pathomorphological terms this is due neither to a ligament rupture nor to an osteochondral lesion. Clinically, local pain in the sinus tarsi is associated with pain during supination or pronation, pain during walking, especially on uneven ground, and "giving way" without signs of mechanical instability. A more severe variant of this syndrome, in which the patient complains of pain on the medial aspect of the hindfoot in conjunction with the typical pain of the sinus tarsi syndrome is described. This medial symptom complex has been identified as the "canalis tarsi syndrome". Injection of a steroid and local anaesthetic agent into the tarsal sinus or tarsal canal will relieve the pain if the underlying pathology is that of a tarsi syndrome, depending on which side the injection is given. An arthrogram of the subtalar joint in a patient with a confirmed sinus tarsi syndrome demonstrates a sac-like anterior bulge of the capsule. Performed on a non-pathologic tarsal sinus, this procedure would demonstrate a corrugated appearance of the capsule anteriorly, without this anterior protrusion. At the Medical School in Hanover, 95 patients with a sinus tarsi syndrome were assessed between 1981 and 1989. In all patients a conservative regimen of repeated injections (6 or fewer) of a steroid and local anaesthetic agent into the tarsal sinus was instituted. In addition, 3 of these patients were identified as having a canalis tarsi syndrome, and injections were simultaneously given into their tarsal canals.(ABSTRACT TRUNCATED AT 250 WORDS)