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Talus bone

The talus bone, also known as the ankle bone or astragalus, is an irregularly shaped tarsal bone in the human hindfoot that serves as the primary connector between the lower leg and the foot, articulating superiorly with the tibia and fibula to form the ankle joint while transmitting body weight downward to the rest of the foot.^[1]^[2] It is the second largest bone in the foot after the calcaneus, characterized by a saddle-like structure with no muscular attachments and approximately 60% of its surface covered in articular cartilage, which facilitates smooth joint motion.^[1]^[3] The bone's unique anatomy enables essential movements of the ankle and foot, including dorsiflexion, plantarflexion, inversion, and eversion, through its involvement in the talocrural, subtalar, and transverse tarsal joints.^[1]^[2] Structurally, the talus comprises three main components: the head, which articulates anteriorly with the navicular bone and inferiorly with the calcaneus via multiple facets; the neck, a constricted region that slopes downward and medially, connecting the head to the body and containing the sulcus tali that forms part of the tarsal sinus; and the body, featuring the trochlear (dome) surface superiorly for the ankle mortise, as well as medial, lateral, and posterior processes that support ligamentous attachments.^[1]^[3] Its blood supply is tenuous, primarily derived from branches of the posterior tibial, peroneal, and anterior tibial (dorsalis pedis) arteries, with limited vascularity in the neck and body regions increasing the risk of avascular necrosis following injury.^[1] Clinically, the talus is notable for its fracture susceptibility—accounting for about 1% of all lower extremity fractures but up to 50% of hindfoot fractures—often resulting from high-energy trauma like falls or sports injuries, and it is prone to complications such as osteoarthritis, osteochondral lesions, and tarsal tunnel syndrome due to its weight-bearing role and poor healing potential.^[1]^[2] Developmental variations, including congenital vertical talus or accessory ossicles like the os trigonum, can also affect foot alignment and function.^[3]

Anatomy

Structure

The talus is an irregularly shaped tarsal bone in the human foot, characterized by its lack of muscular attachments and extensive articular surfaces, making it unique among the tarsal bones. It consists of three main components: the head, neck, and body, with the body being the largest portion. The bone's morphology supports its role as a connector between the leg and foot, with approximately 60% of its surface covered by articular cartilage.^[1] The talar head is a rounded anterior projection that forms the most distal part of the bone, featuring a convex, ovoid anterior surface. This head is separated from the neck by a slight constriction and is almost entirely enveloped in hyaline cartilage on its anterior and superior aspects. Inferiorly, the head bears three articular facets—anterolateral, anteromedial, and middle—divided by ridges, contributing to its complex contour.^[3]^[1] The neck of the talus is a constricted region connecting the head to the body, oriented obliquely in an inferomedial direction. It is narrower than both adjacent parts, measuring on average about 3.3 cm in width, and its inferior surface contains the sulcus tali, a deep groove that expands laterally into the sinus tarsi. This narrow neck renders it particularly susceptible to fractures due to its limited cross-sectional area.^[1]^[4] The body of the talus represents the largest and most robust portion, encompassing the superior trochlea and posterior elements. It includes a lateral process on its inferolateral aspect and a posterior process that bifurcates into medial and lateral tubercles separated by a groove. The medial tubercle is smaller and projects more inferiorly, while the lateral tubercle is larger and more prominent. These tubercles and processes provide attachment points for ligaments, enhancing stability. The body's overall dimensions average approximately 5.4 cm in length, 4.1 cm in width, and 3.1 cm in height, varying slightly by sex and population.^[1]^[3]^[4] The trochlea, or talar dome, forms the pulley-shaped superior surface of the body, presenting a convex, wedge-shaped convexity that is broader anteriorly (average width ~3.0 cm) than posteriorly (~2.3-2.6 cm). This anterior-posterior asymmetry contributes to the bone's tapered profile, with the trochlear surface gently curved in the sagittal plane and mildly concave in the coronal plane. Laterally and medially, the body features comma-shaped malleolar facets for interaction with the distal tibia and fibula, while the posterior aspect of the inferior surface includes a concave calcaneal articular facet.^[1]^[4]^[5]

Articulations and ligaments

The talus bone forms several key articulations in the foot, primarily serving as a connector between the leg and the hindfoot. The talocrural joint, also known as the ankle joint, is a synovial hinge joint where the superior trochlea of the talus articulates with the inferior surfaces of the distal tibia and the medial malleolus of the fibula, allowing for dorsiflexion and plantarflexion movements.^[1] This articulation is reinforced by the surrounding ligaments and transmits forces from the lower leg to the foot.^[1] Inferiorly, the talus articulates with the calcaneus at the subtalar joint, a compound synovial joint comprising posterior, middle, and anterior facets; the posterior and middle facets on the talus specifically interface with corresponding surfaces on the calcaneus, facilitating inversion and eversion of the foot.^[1] The head of the talus articulates anteriorly with the navicular bone, forming part of the transverse tarsal joint (also called the Chopart joint), which connects the hindfoot to the midfoot and contributes to the foot's adaptability during weight-bearing.^[1] These articulations collectively enable the talus to link the ankle to the subtalar and midtarsal regions without direct muscular attachments, relying instead on ligamentous stability.^[1] The ligaments associated with the talus provide crucial medial and lateral support to these joints. On the medial side, the deltoid ligament, a strong triangular complex, originates from the medial malleolus of the tibia and fans out to attach to the talus, calcaneus, and navicular; it consists of superficial components (such as the tibionavicular and tibiocalcaneal ligaments) and deeper posterior tibiotalar fascicles, collectively resisting eversion and talar abduction.^[6] Laterally, the collateral ligament complex includes three primary bands: the anterior talofibular ligament (ATFL), which extends from the anterior inferior lateral malleolus of the fibula to the anterior aspect of the talar neck, limiting anterior talar displacement and inversion during plantarflexion; the calcaneofibular ligament (CFL), running from the lateral malleolus to the lateral calcaneus, stabilizing both the talocrural and subtalar joints in neutral and dorsiflexed positions; and the posterior talofibular ligament (PTFL), connecting the posterior lateral malleolus to the posterior talus, providing posterior stability and resisting excessive dorsiflexion.^[6]^[7] The sinus tarsi and tarsal canal play integral roles in ligament passage and joint stabilization. The sinus tarsi, a lateral bony depression between the talus and calcaneus, contains the cervical and interosseous talocalcaneal ligaments, which reinforce the subtalar joint and provide proprioceptive feedback.^[1] Extending medially from the sinus tarsi, the tarsal canal is a narrower osseous tunnel that accommodates the interosseous talocalcaneal ligament and branches of the posterior tibial artery, further securing the posterior aspect of the subtalar joint against shear forces.^[1]

Blood supply and innervation

The talus bone receives its arterial blood supply primarily from three major sources: the posterior tibial artery, the anterior tibial artery (also known as the dorsalis pedis artery), and the peroneal artery. The posterior tibial artery contributes through branches that supply the medial and lateral tubercles via the posterior tubercle and forms the tarsal canal artery, which provides the dominant supply to the talar body, including a deltoid branch for the medial third. The anterior tibial artery supplies the superomedial aspect of the talar neck via medial tarsal branches, while the peroneal artery anastomoses with the dorsalis pedis to form the tarsal sinus artery, which together with the tarsal canal artery supplies the inferolateral talar neck. These arteries enter the talus through vascular foramina on its non-articular surfaces, with key branches including the sinus tarsi artery and deltoid branches.^[1]^[8]^[9] Venous drainage of the talus follows the arterial supply, primarily via the peroneal and posterior tibial veins, which converge into the venous plexuses of the foot and ankle.^[1] Intraosseous circulation within the talus is limited due to its extensive articular cartilage coverage, which encompasses approximately 60-70% of its surface, making the bone heavily reliant on extraosseous vascular supply with minimal anastomoses between the major arterial branches. This precarious intraosseous network contributes to the talus's vulnerability to ischemia, particularly when extraosseous vessels are compromised.^[1]^[9] Innervation to the talus is predominantly sensory, derived from branches of the deep peroneal nerve (supplying the dorsal aspect), the tibial nerve (including posterior tibial branches for the medial side), and the sural nerve (for lateral sensory feedback), with no significant motor innervation due to the absence of muscular attachments. Additional contributions come from the saphenous nerve medially and branches of the superficial peroneal nerve for the dorsolateral and lateral regions.^[1]^[10] The talar neck represents a critical watershed area with tenuous blood supply, rendering it particularly susceptible to ischemia and avascular necrosis following disruption of the extraosseous vessels.^[1]^[9]

Function

Role in locomotion

The talus bone serves as a critical intermediary in the lower limb, transmitting body weight from the tibia to the foot bones during the stance phase of locomotion. Positioned at the ankle joint, it receives the vertical forces generated by body mass and redistributes them across the tarsal bones, enabling efficient weight-bearing while maintaining structural integrity. This transmission is essential for activities such as walking and standing, where the talus acts as a pivot to transfer up to several times the body's weight without compromising mobility.^[11] In facilitating ankle movements, the talus enables dorsiflexion, ranging from 0 to 20 degrees, which lifts the foot upward to clear obstacles during the swing phase, and plantarflexion, up to 50 degrees, which points the foot downward for propulsion. At the subtalar joint, the talus articulates with the calcaneus to permit inversion and eversion, allowing the foot to adapt to uneven terrain by tilting medially or laterally, thus enhancing balance and directional changes during locomotion. These motions collectively ensure smooth transitions between phases of movement, integrating the talus's role in both the talocrural and subtalar joints.^[12]^[13] During the gait cycle, the talus contributes to heel strike absorption by cushioning initial ground contact through controlled dorsiflexion and eversion, dissipating impact forces to prevent jarring. In the push-off phase, it supports propulsion via plantarflexion and inversion, generating forward momentum as the body advances. This integration optimizes energy efficiency and stride length in walking and running.^[14] The talus also provides stability in upright posture by forming a key component of the medial longitudinal arch, which supports the foot's vaulted structure and distributes weight evenly to maintain equilibrium without excessive strain on surrounding tissues. This arch configuration, with the talus as its keystone, resists collapse under gravitational load, facilitating prolonged standing and bipedal posture.^[15]^[16]

Biomechanics

The talus serves as a pivotal structure in the lower limb's load transmission pathway, articulating with the tibia and fibula to transfer compressive forces from the body to the foot. During normal walking, the ankle joint complex, with the talus at its core, experiences peak loads of approximately five times body weight, escalating to up to thirteen times body weight during activities like running. The trochlear surface of the talus, characterized by its wedge-shaped morphology—wider anteriorly than posteriorly—facilitates this transmission while resisting anterior translation, thereby maintaining joint stability under dynamic loading. This design ensures efficient force distribution to the subtalar and transverse tarsal joints, with the tibiotalar articulation handling about 83% of the axial load and the talar dome supporting 77–90% of the tibial-talar interface forces.^[17]^[18]^[17] Joint congruence in the talocrural articulation varies with position, influencing load distribution and minimizing stress concentrations. In the neutral position, the contact area between the talar trochlea and tibial plafond is relatively limited, typically around 4–5 cm² under physiological loads, representing less than 50% of the available cartilage-covered surface to allow for mobility. This area expands significantly during dorsiflexion, reaching up to 7.3 cm² at 20° of dorsiflexion, which enhances congruence by engaging more of the broader anterior trochlea within the mortise, thereby optimizing force dissipation across the joint. Such positional changes in contact area are critical for accommodating the ankle's multiplanar demands without excessive wear.^[19]^[20] Stress distribution across the talar surfaces reflects these biomechanical adaptations, with compressive forces concentrated on the trochlear dome during weight-bearing. Under static loads equivalent to twice body weight (approximately 1.5 kN), mean contact pressures on the talocrural joint reach 9.9 MPa, with higher values observed in plantarflexion due to reduced contact area compared to dorsiflexion. These stresses are unevenly distributed, often peaking anterolaterally in neutral positions, underscoring the talus's role in buffering peak forces through its geometric and material resilience.^[17] Motion kinematics of the talus involve coupled interactions between the talocrural and subtalar joints, enabling triplanar foot motion. For instance, talocrural dorsiflexion or plantarflexion in the sagittal plane induces corresponding eversion or inversion at the subtalar joint, with the subtalar contribution accounting for about 20% of the total ankle complex's sagittal range of motion (typically 65–75° overall). A representative coupling ratio shows that 10° of talocrural motion may elicit 2–5° of subtalar motion, depending on the plane and loading, facilitating adaptive pronation and supination during gait. The cortical bone of the talus, with an apparent density of 1.2–1.8 g/cm³ and a modulus of elasticity of 15–20 GPa, provides the necessary stiffness to withstand these kinematic demands without deformation.^[17]^[21]^[22]^[23]

Development and variations

Ossification and growth

The talus bone originates embryologically from the somatic layer of the lateral plate mesoderm, which contributes to the formation of the limb skeleton during early development.^[24] The lower limb bud emerges around the fourth week of gestation, with mesenchymal condensation leading to the cartilage anlage of the talus by the seventh week, establishing its precartilaginous model prior to ossification.^[25] This endochondral process follows the typical pattern for tarsal bones, where the initial hyaline cartilage template defines the bone's future morphology. The primary ossification center for the talus appears in the body of the bone during the sixth to eighth month of fetal life, typically around seven months in utero, marking the onset of endochondral ossification.^[26] Unlike long bones, the talus lacks secondary ossification centers and epiphyseal growth plates; instead, postnatal growth occurs primarily through periosteal apposition, where new bone is deposited on the outer surfaces to increase size and shape the bone progressively.^[27] By three months postnatal, approximately 55% of the talus is ossified, with continued expansion leading to largely complete ossification of the main body by around six years of age.^[27] Ossification and growth of the talus complete by puberty, with the posterior process potentially involving a separate center (os trigonum) that fuses between ages 7-10 in females and 9-12 in males, though this is not universal.^[27] Sex differences are evident throughout development, with females exhibiting earlier and more advanced ossification centers in the talus and other tarsal bones compared to males at equivalent gestational or postnatal ages, reflecting broader skeletal dimorphism.^[28]

Anatomical variations

The os trigonum represents one of the most common anatomical variations of the talus, manifesting as an accessory ossicle derived from the unfused ossification center of the posterolateral tubercle. This variant occurs in 7-25% of individuals, with higher detection rates on imaging such as CT scans where prevalence reaches up to 30% in asymptomatic populations.^[29]^[30] Although typically benign, it can become symptomatic in activities involving repetitive plantar flexion, particularly among ballet dancers, where it contributes to posterior ankle impingement through compression of adjacent soft tissues.^[31]^[32] Variations in the lateral talar tubercle include elongation, termed Stieda's process, and less commonly bifid configurations, which alter the posterior contour and may impinge on the sinus tarsi, potentially leading to lateral ankle discomfort.^[31]^[33] These forms arise from incomplete fusion during development and have a reported prevalence of 1-15% depending on the population studied, with elongated variants more frequently associated with mechanical overload in dynamic ankle movements.^[34] Trochlear ridge anomalies encompass deviations in the shape of the talar dome, such as flat or excessively domed profiles, which affect joint congruence and stability. A flat trochlea reduces the depth of the articular surface and has been linked to diminished tibiotalar stability, increasing susceptibility to subluxation.^[35] Size asymmetries between left and right tali reflect fluctuating asymmetry in skeletal development.^[36] Racial variations further influence dimensions, with studies indicating longer talar lengths in African populations compared to Caucasians or Asians, aiding in population affinity assessments.^[37] Recent investigations have expanded understanding of these variants. A 2024 atlas based on over 900 tali documented more than 15 distinct morphological variants, including facet and tubercle anomalies, establishing a standardized nomenclature to facilitate clinical and bioanthropological applications.^[38]

Clinical significance

Fractures and injuries

Talus fractures are relatively uncommon, accounting for less than 1% of all fractures and 3% to 6% of foot fractures.^[9] These injuries typically result from high-energy trauma, such as motor vehicle accidents or falls from height, which impose axial loads on the dorsiflexed foot, or from lower-energy mechanisms like repetitive stress in activities involving jumping, as seen in athletes.^[9]^[39] The talus's precarious blood supply, detailed in anatomical descriptions, heightens the risk of complications when these vascular structures are disrupted.^[9] Classification systems guide management, with the Hawkins classification (modified by Canale) applied to talar neck fractures, the most common type: Type I involves nondisplaced fractures; Type II features subtalar subluxation or dislocation; Type III includes both subtalar and ankle joint involvement; and Type IV extends to talonavicular dislocation.^[9] For talar body fractures, the Sneppen classification delineates types based on fracture plane, such as coronal or sagittal shear, or comminuted crush patterns.^[9] Diagnosis relies on imaging, where computed tomography (CT) is the gold standard with superior accuracy over plain X-rays, which have approximately 60% sensitivity for detecting and classifying talar injuries, as shown in a 2025 meta-analysis.^[40] Complications are frequent due to the talus's limited vascularity, with avascular necrosis occurring in 20-50% of displaced neck fractures (rising to over 90% in Types III and IV) from disruption of retinacular vessels.^[9]^[39] Nonunion affects 10-20% of cases, particularly in comminuted body fractures, while malunion can lead to joint incongruity.^[9] Treatment for nondisplaced fractures involves immobilization in a cast for 6-8 weeks, whereas displaced fractures require open reduction and internal fixation (ORIF) using screws to restore alignment; severe comminuted or Hawkins Type IV injuries may necessitate primary arthrodesis to prevent collapse.^[9]^[39] Outcomes vary by fracture severity and timeliness of intervention, with post-traumatic arthritis developing in 40-60% of patients, predominantly affecting the subtalar and tibiotalar joints, and leading to chronic pain and stiffness.^[41] Rehabilitation emphasizes early motion preservation through protected weight-bearing protocols to mitigate stiffness, though functional scores like the AOFAS hindfoot scale often remain moderate (around 70-80 points) in displaced cases.^[9]^[39]

Other disorders

Osteochondritis dissecans (OCD) of the talus primarily affects the talar dome and represents approximately 4% of all osteochondral lesions.^[42] These lesions involve focal disruption of the subchondral bone and overlying articular cartilage, often leading to pain, swelling, and mechanical symptoms such as catching or locking in the ankle joint. The condition is classified into stages I through IV using the Berndt-Harty system, which assesses lesion stability and fragmentation: stage I indicates subchondral compression, stage II shows incomplete fracture, stage III denotes a nondisplaced fragment, and stage IV involves a displaced or loose fragment.^[43] Early detection via MRI is crucial, as progression can result in cartilage degeneration and osteoarthritis if untreated. Avascular necrosis (AVN) of the talus, also known as osteonecrosis, arises from disrupted blood supply and can be idiopathic or post-traumatic, with the latter often following injuries that compromise the talus's retrograde vascularity.^[44] The Ficat and Arlet staging system is applied to talar AVN, progressing from stage I (preradiographic necrosis detectable by MRI) to stage IV (advanced collapse with secondary arthritis). Approximately 15-30% of cases progress to subchondral collapse, particularly in shoulder-type lesions involving the talar neck or body, leading to pain, stiffness, and joint deformity.^[45] Management focuses on preserving bone viability in early stages through non-weight-bearing protocols, though advanced collapse often necessitates surgical intervention like core decompression. Talar coalition refers to anomalous bony, cartilaginous, or fibrous union between the talus and adjacent tarsal bones, most commonly the talocalcaneal joint, with a prevalence of 1-2% in the general population.^[46] This congenital condition restricts subtalar motion, causing rigid flatfoot, recurrent ankle sprains, and peroneal spasm due to compensatory muscle hyperactivity. Talocalcaneal coalitions, accounting for about 37% of tarsal coalitions, often manifest in adolescence as the coalition ossifies, leading to hindfoot valgus and potential secondary osteoarthritis. Diagnosis relies on imaging features like the C-sign on lateral radiographs, with treatment ranging from orthotics to resection for symptomatic cases. Tumors of the talus are rare, comprising less than 3% of primary bone neoplasms, with benign lesions predominating. Chondroblastoma, a benign cartilaginous tumor arising from epiphyseal chondroblasts, occurs in 1-3% of all bone tumors and involves the talus in about 4% of its cases, typically presenting with pain and swelling in young patients aged 10-20 years.^[47] These lytic lesions with chondroid matrix may mimic infection or AVN radiographically. Intraosseous lipomas, benign fatty tumors accounting for 0.1-2.5% of bone tumors, can also affect the talus, often appearing as well-defined cystic lesions with fat attenuation on MRI and rarely causing symptoms unless fractured. Malignant tumors like osteosarcoma are exceptionally uncommon in the talus. Infections involving the talus, such as post-injury osteomyelitis, occur when bacteria invade bone following trauma, leading to bone destruction, abscess formation, and chronic pain if not promptly treated with antibiotics and debridement.^[48] Gouty arthropathy can affect the talus through urate crystal deposition, forming tophi that erode subchondral bone and induce osteochondral lesions, mimicking trauma or necrosis with acute inflammatory flares and joint effusion.^[49] These tophaceous deposits, seen in advanced hyperuricemia, may cause cystic changes or pathologic fractures, emphasizing the need for serum uric acid monitoring in atypical ankle pathologies.

Comparative and historical aspects

In other animals

In quadrupedal mammals adapted for cursorial locomotion, such as horses, the talus exhibits an elongated morphology that facilitates efficient propulsion and stability during high-speed, straight-line movement. This adaptation supports the animal's ability to cover large distances rapidly, with the talus forming a key component of the hock joint alongside the calcaneus and other tarsal bones.^[50] In equids, the talus contributes to the overall rigidity of the tarsus, enhancing force transmission from the hindlimb to the ground.^[51] Among primates, the talus shows notable variations tied to locomotor styles, with arboreal species like gibbons displaying a reduced overall size and a more mobile talar head to accommodate flexible foot movements during brachiation and leaping. This morphology, characterized by lower curvature in the talar head and sustentaculum facets, promotes transverse tarsal joint mobility and elastic energy storage in the foot, aiding in agile arboreal navigation.^[52] In contrast, more terrestrial primates exhibit talar features suited to weight-bearing, though gibbons' design emphasizes dorsiflexion and inversion for grasping branches.^[53] In birds, the talus, or astragalus, is evolutionarily incorporated into the proximal tarsals that fuse with the tibia to form the tibiotarsus, while the distal tarsals merge with the metatarsals to create the tarsometatarsus, an elongated bone analogous to the mammalian tarsus for weight support during perching or walking. This fusion pattern enhances lightweight leg structure for flight in most species. In flightless birds, such as ostriches and emus, the tarsometatarsus and associated structures become robustly developed rather than vestigial, with increased cross-sectional thickness and length to support graviportal terrestrial locomotion and high-speed running.^[54]^[55] Evolutionary trends in the talus trace back to basal amniotes, where the astragalus and calcaneum originated as separate elements but underwent fusion in the proximal tarsus for enhanced terrestrial stability; in reptiles like mesosaurs, the astragalus forms via early ontogenetic fusion of the intermedium, tibiale, and proximal centralia, while the calcaneum derives from the fibulare and remains distinct. This separation persists and diversifies in mammals, allowing greater ankle mobility compared to the more rigid reptilian configurations, reflecting adaptations from sprawling to upright postures.^[56]^[57] Veterinarily, talus fractures hold significant importance in performance equines like racehorses, where stress-induced injuries predominate due to repetitive high-impact loading. Sagittal or incomplete fractures, often arising from maladaptive bone remodeling under compression, shear, and torsional stresses, are rare but can cause severe lameness and career-ending damage, particularly in the proximal trochlear groove.^[58]^[59] Early detection via MRI or CT is crucial, as these microfractures may underlie catastrophic failures and require prolonged rest or arthroscopic intervention for recovery.^[60]

Etymology and use as dice

The term "talus" originates from the Latin word talus, which denoted the ankle or anklebone and was also applied to dice fashioned from such bones.^[61]^[62] This nomenclature reflects the bone's historical dual role in anatomy and gaming. The Greek equivalent, astragalos, similarly referred to the ankle bone of animals like sheep or goats and extended to knucklebones used as rudimentary dice, highlighting a shared Indo-European linguistic root tied to both skeletal structure and play.^[63] Astragali, the knucklebones derived from the talus of sheep, goats, or cattle, served as precursors to modern dice due to their natural irregular shape, featuring four relatively flat sides suitable for landing unpredictably.^[64] These sides were often marked with values such as 1, 3, 4, and 6, providing inherent randomness without needing carving, unlike later cubic forms. In ancient Rome, the game of tali involved throwing four such bones, with outcomes scored based on the upward-facing sides; the highest throw, Venus, occurred when all four showed different sides (1, 3, 4, and 6), while the lowest, Canis, featured all 1s.^[65]^[66] Beyond gaming, astragali held ritual importance, particularly in divination practices known as astragalomancy. In ancient Greece, oracles cast five knucklebones—each valued at 1, 3, 4, or 6—to interpret outcomes from 32 possible combinations, often invoking deities like Apollo for guidance.^[67]^[68] This method persisted into Roman and medieval periods for fortune-telling, especially among women, before evolving into more standardized board games.^[69] By the 14th century, knucklebones largely gave way to six-sided cubic dice in Europe, which offered greater fairness through symmetry and uniform numbering from 1 to 6, marking a shift from organic to manufactured gaming tools.^[70] Astragali appear frequently in archaeological contexts, underscoring their cultural ubiquity; for instance, ivory examples were interred in Tutankhamun's tomb around 1323 BCE, likely for use in the afterlife.^[71] In Greek mythology, the talus indirectly evokes vulnerability through the Achilles' heel motif, where the hero's unprotected tendon insertion at the heel symbolizes a fatal weakness, though the bone itself was not the precise target.^[72] Today, the term "talus" endures in architecture to describe the sloping base of a fortified wall, thicker at the bottom for stability, a usage derived from the bone's sloped contours.^[73]^[74]

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Feb 18, 2025 · Primary ossification centers present at birth · calcaneus: 6 months in utero · talus: 7 months in utero · cuboid: 9 months in utero · metatarsals: 9 ...
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Trabecular bone ontogeny of the human talus - Reid
Sep 15, 2025 · ... the second rocker phase, when the talus experiences peak load transmission as it mediates the transfer of body weight through the foot.
[28]
Paper - Difference in the ossification of the male and female skeleton (1928) - Embryology
### Summary of Sex Differences in Ossification of Foot Bones, Particularly Talus
[29]
Os trigonum | Radiology Reference Article | Radiopaedia.org
Jul 28, 2025 · It is estimated to be present in ~7% of adults 1. Bilateral ossa trigona are seen in 2% of individuals 3. The ossicle usually forms between 7 ...Posterior ankle impingement · Posterior talar process fracture · Question 2120
[30]
Prevalence of Os Trigonum on CT Imaging - PubMed
This study showed that os trigonum is a common accessory bone. With a prevalence of 30.3% in a population of patients with CT imaging of both ankles and 23.7% ...
[31]
Anatomical variation in the ankle and foot: from incidental finding to ...
Jul 31, 2019 · This review aims to describe and illustrate the imaging findings related to the presence of accessory ossicles and muscles in the ankle and hindfoot through ...
[32]
Lower Extremity Os - Foot & Ankle - Orthobullets
Oct 9, 2025 · Accessory bone. Prevalence. Clinical significance ; Os trigonum. 10-25%. Posterior ankle impingement, FHL entrapment ; Type II accessory navicular.
[33]
Posterior Ankle Impingement - Radsource
The lateral tubercle of the talus, when elongated, is referred to as Stieda's process (7a,8a). In addition, the lateral tubercle may articulate with a ...Missing: variations | Show results with:variations
[34]
[PDF] A Comprehensive Study of the Anatomical Variations of the ...
SUMMARY: The aim of our study was to determine the prevalence and the anatomical variations of the posterolateral tubercle of talus in relation to sex on CT ...
[35]
Functional Implications of Flat-Topped Talus Following Treatment of ...
Mar 13, 2023 · This study analyzes the relationship between TD morphology and ankle function at skeletal maturity in patients treated for idiopathic clubfoot during infancy.Missing: trochlear ridge stability
[36]
Alterations in Talar Morphology Associated with Adult Flatfoot
This study is an attempt to understand three-dimensional alterations in flat foot. The shape of the talus is not easily described.
[37]
Symmetry analysis of talus bone: A Geometric morphometric approach
May 1, 2014 · The main object of this study was to use a geometric morphometric approach to quantify the left-right symmetry of talus bones.
[38]
Measurements of the talus in the assessment of population affinity
Talar measurements can be used to discriminate between populations in South Africa. Talar length and head height are best single variables for discriminating ...
[39]
An Atlas of Anatomical Variants of the Human Talus
Dec 28, 2024 · As the fusion of the os trigonum accessory bone is usually around the age of 8−13 years old (Cicek and Bankaoglu 2020) or 7−13 years, it is ...
[40]
Talus Fractures
The most significant complication of talus fractures is avascular necrosis (AVN) due to the non-redundant blood supply of the talus. Fractures of the talar ...
[41]
Diagnostic accuracy of plain radiographs compared to CT scans in ...
Oct 1, 2025 · The sensitivity of the X-ray for talus neck was better than other major talus fractures and was calculated at 76.73% (95% CI: 72.94% − 80.52%), ...
[42]
Fractures of the Talus: Current Concepts - PMC - NIH
Feb 13, 2020 · Talus fractures are relatively rare injuries (Table 1); they are estimated to account for 0.1% to 2.5% of all fractures, and 3% to 5% of foot ...
[43]
Osteochondral Lesions of the Talus | Musculoskeletal Key
Feb 27, 2020 · OLTs represent approximately 4% of all osteochondral lesions. In 1955, investigators reported a frequency of 6.5% in their series of 133 ankle ...<|separator|>
[44]
Osteochondritis dissecans of the talus - PMC - PubMed Central - NIH
Treatment of OCD is guided by the patient's age at the onset of symptoms, their severity, and the disease stage according to the Berndt and Harty classification ...
[45]
Avascular Necrosis of the Talus: Diagnosis, Treatment, and Modern ...
Oct 15, 2024 · Talar avascular necrosis (AVN) is a devastating condition that frequently follows type III and IV talar neck fractures.Missing: mechanisms | Show results with:mechanisms
[46]
Management Options in Avascular Necrosis of Talus - PMC
Any AVN talus case is first staged based on MRI and radiographs (FA staging). Attention is given to determine collapse and identify the sclerotic zones.
[47]
Talocalcaneal Coalition - StatPearls - NCBI Bookshelf
Jan 30, 2024 · The prevalence of the tarsal coalition is 1% to 2%, although cadaveric studies have established a prevalence of 13%[9]. The talocalcaneal ...
[48]
Chondroblastoma of the Talus: A Case Report and Literature Review
Nov 7, 2011 · Chondroblastoma is a rare, benign cartilaginous neoplasm that accounts for approximately 1% of all bone tumors, and approximately 4% of all ...
[49]
Ankle osteomyelitis: an unusual presentation - PMC - NIH
May 29, 2013 · We present a case of a traumatic cause of osteomyelitis affecting the hindfoot bones and resulting in significant bone injury and disability from a closed ...
[50]
Osteochondral lesion of talus with gout tophi deposition: A case report
Sep 6, 2020 · Osteochondral lesion of talus is a broad term used to describe an injury or abnormality of the talar articular cartilage and adjacent bone.
[51]
HORSE SPECIES SYMPOSIUM: Biomechanics of the exercising horse
In spite of having large height and body mass, horses are cursorial animals with an extensive gait repertoire and considerable athletic abilities.
[52]
Talus - vet-Anatomy - IMAIOS
The talus is medial to the calcaneus in the proximal row of tarsus. It is divided into: A head (in carnivores) at the base of the bone, that articulates ...
[53]
Three-dimensional shape variation of talar surface morphology in ...
Hominoid primates display a variety of locomotor types with varying degrees of adaptation to arboreal and terrestrial locomotion. Hylobatids (gibbons and ...
[54]
https://pmc.ncbi.nlm.nih.gov/articles/PMC11564758/
[55]
Evolution of avian foot morphology through anatomical network ...
Nov 14, 2024 · The avian foot is characterized by the fusion of metatarsals II-IV forming the tarsometatarsus. All digits contact the tarsometatarsus and all ...
[56]
The legs: A key to bird evolutionary success - ResearchGate
Aug 6, 2025 · The legs always have three long bones, and all the birds walk on their toes. This leg structure is a striking plesiomorphic feature that was already present in ...
[57]
The ontogenetic transformation of the mesosaurid tarsus
The origin of the astragalus and the calcaneum in the ankle of basal amniotes has been considered as an adaptation to terrestrial locomotion and a key ...Missing: trends talus
[58]
https://avmajournals.avma.org/view/journals/javma/255/1/javma.255.1.102.xml
[59]
Incomplete fracture of the talus secondary to maladaptive stress ...
Jul 1, 2019 · Although rare, incomplete fracture of the talus should be considered as a differential diagnosis for horses that develop acute hind limb lameness following ...
[60]
Fracture of the Talus in Horses - Musculoskeletal System
Sagittal fractures of the talus are rare and have been most commonly reported in racehorses. Lameness is usually moderate to severe and associated with ...
[61]
https://www.etymonline.com/word/talus
[62]
Talus - Etymology, Origin & Meaning
"Talus" originates from Latin, meaning "anklebone," linked to dice made from knucklebones, and from Old French, meaning "slope," derived from Gallo-Roman ...Talus(n. 1) · Talus(n. 2) · Entries Linking To Talus
[63]
Talus - English Definition & Meaning - WordZo
Etymology. The word "talus" comes from the Latin word "talus," meaning "ankle," "anklebone," or "dice." The ancient Romans used tali (knucklebones) as dice, ...
[64]
Musculoskeletal etymology: What's in a name? - PMC
The earlier name for talus was astragalus, which too refers to dice in Greek. ... The second cervical vertebra (or axis) was also earlier called as astragalus, as ...2. Musculoskeletal Etymology · 2.1. Lower Limb · 2.2. The Upper Limb
[65]
Astragali, the Ubiquitous Gaming Pieces - Penn Museum
The astragals in sheep, goats, and most deer is about twice the size of modern dice and of the “shooter” I used in my tenure as a marble player.
[66]
Dice in ancient Roman world - IMPERIUM ROMANUM
Apr 23, 2021 · Tali. tali(singular: talus) was Ancient Rome, the so-called astragalas – one of the oldest game-related items known to mankind.
[67]
The Ancient Roman Dice Game of Tali - Hidden History
Jun 10, 2025 · The earliest “dice” were unmodified ankle bones from sheep, goats, pigs or deer (known in Greek as an “astragalos”, plural “astragaloi”, and ...
[68]
A Greek Alphabet Oracle - John Opsopaus, PhD
Apr 21, 2024 · Since each knucklebone has four “sides,” traditionally given the values 1 (Monas), 3 (Trias), 4 (Tetras), and 6 (Hexas), there are 24 possible ...
[69]
[PDF] Astragaloi Handout - Lady of Bones
Astragalomancy is a Greek variation on dice oracles. Archaeological sites from around the. Mediterranean, especially those from the second century CE contain ...
[70]
Rare assemblage of knuckle bones for gaming and divination ...
Aug 16, 2022 · The “astragali”—knuckle bones of goats, sheep and cattle—were used similarly to dice for gaming and for ritual divination, mainly by women and ...
[71]
(PDF) The Evolution of Cubic Dice: From the Roman Through Post ...
Jan 17, 2018 · The first dice were invented as far back as before the year 400, but the first balanced and functional dice, have been dated to about 1450 in ...
[72]
Integrating Zooarchaeology Chapter 16: Astragali through Time | TOTA
At Amarna in Egypt, a green-glazed faience skeuomorph was discovered and there were two ivory astragali found in Tutankhamun's tomb. At the necropolis at Varna ...
[73]
Achilles' heel? - Origins of a hero's weak point
Sep 22, 2020 · One of the main traits of the temperamental hero Achilles is that he is invulnerable to harm except for his proverbial heel.
[74]
Talus - Designing Buildings Wiki
Aug 4, 2021 · The term 'talus' describes sloped fortifications at the base of certain types of military structures. The talus is typically larger than a batter.
[75]
talus - Wiktionary, the free dictionary
... sloping pile of loose rock. (architecture) The slope of an embankment wall, which is thicker at the bottom than at the top. Coordinate terms. colluvium · scree ...