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The tibia is the main weight-bearing bone of the lower leg. It is larger than the fibula with which it is paired. The tibia is also the second longest bone in the body and is located right below the skin. The proximal end of the tibia forms the medial and the lateral condyle, which articulates with the condyles of the femur to form the knee joint. Between the articulating surfaces is the irregular elevated area known as the intercondylar eminence that serves as the inferior attachment point for...
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Muscles of the Leg that Move the Foot and Toes01:28

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The human leg comprises an intricate system of muscles that facilitate the movement of feet and toes. Within this system, the muscles are categorized into the anterior, lateral, and posterior compartments, each with a unique set of muscles carrying out specific functions.
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The femur is the body's longest and strongest bone spanning the thigh region. Its head articulates with the acetabulum of the hip bone to form the hip joint. A minor indentation on the medial side of the femoral head, called the fovea capitis, serves as the site of attachment for the ligament of the head of the femur. This weak ligament spans the femur and acetabulum and supports the hip joint. The narrowed region below the head is the neck of the femur. The inclination angle between the...
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The knee joint is the most complicated joint in the body. It consists of three articulations– two tibiofemoral and one patellofemoral. As is characteristic of synovial joints, the knee joint has a thin articular capsule that partially surrounds this joint cavity. Additionally, several ligaments, muscles, and cartilaginous structures support the movement of the knee.
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Sequential correction of clubfoot deformities with Ponseti casting and tenotomy: Insights from the Dimeglio scoring framework.

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Updated: Mar 24, 2026

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Talar Index: A New Radiologic Marker for Clubfoot Equinus.

Varun Garg1, Anil Agarwal2, Sunny Bhalla3

  • 1Department of Orthopedics, AIIMS, Guwahati.

Journal of Pediatric Orthopedics
|March 23, 2026
PubMed
Summary
This summary is machine-generated.

The Talar Index accurately assesses residual equinus in clubfoot, aiding treatment decisions. This reliable radiologic marker is simple to use in clinical settings.

Keywords:
CTEVclubfootlateral tibio-calcaneal angleradiographyresidual equinus

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Area of Science:

  • Orthopedics
  • Pediatric Orthopedics
  • Radiology

Background:

  • Residual equinus is a key indicator for tenotomy and recurrence monitoring in clubfoot deformity.
  • Objective assessment of residual equinus is crucial for effective clubfoot management.

Purpose of the Study:

  • To validate a novel radiologic marker, the Talar Index, for objective assessment of residual equinus in idiopathic clubfoot.
  • To evaluate the diagnostic accuracy and reliability of the Talar Index.

Main Methods:

  • A cross-sectional observational study involving infants with idiopathic clubfoot treated with the Ponseti protocol.
  • The Talar Index was assessed against unaffected feet, with validity tested using Receiver Operating Characteristic (ROC) analysis and logistic regression.
  • Interobserver and intraobserver reliability were evaluated using Cohen's kappa.

Main Results:

  • The Talar Index demonstrated high accuracy in identifying residual equinus (94.3%), with sensitivity of 95.9% and specificity of 90.5%.
  • A strong association was found between a positive Talar Index and increased lateral tibiocalcaneal angle (AUC: 0.929, P=0.001).
  • Excellent interobserver (κ=0.84) and intraobserver (κ=0.97) reliability was achieved.

Conclusions:

  • The Talar Index is a valid, reliable, and easily interpretable radiologic marker for assessing residual equinus in clubfoot.
  • Its simplicity and high diagnostic accuracy support its routine clinical use, even in resource-limited settings.