Sustentaculum tali

Last revised by Dr Candace Makeda Moore on 02 Oct 2021

The sustentaculum tali is a horizontal shelf that arises from the anteromedial portion of the calcaneus. The superior surface is concave and articulates with the middle calcaneal surface of the talus. The inferior surface has a groove for the tendon of flexor hallucis longus.

Several ligamentous structures attach to the sustentaculum tali:

Related pathology

The sustentaculum tali is typically involved in cases of tarsal coalition, specifically talocalcaneal coalition and subtalar coalition. In cases of talocalcaneal coalition, the complete C-sign can be seen on a lateral radiograph where there is bridging between the talus superiorly and the posterior portion of the sustentaculum tali inferiorly.

Fracture of the sustentaculum tali is rare, and usually not isolated.  Such fractures usually occur in high-energy activities and should be suspected when the patient presents with pain and hematoma directly over the sustentaculum tali.

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Cases and figures

  • Figure 1: calcaneus (Gray's illustration)
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  • Case 1: with talocalcaneal coalition
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