Talus Bipartitus: A Rare Skeletal Variation
A Report of Four Cases
Stefan Rammelt, MD, PhD; Hans Zwipp, MD, PhD; Andreas Prescher, MD, PhD

Talus bipartitus (also known as talus partitus or frontal split) is a rare anatomic variant of the talus, first described by Strehle in 19281. Since then, to the best of our knowledge, only seven more cases have been described in the medical literature, and all of these cases occurred in adolescents who were between thirteen and eighteen years of age2-7. Three recent reports utilized a computed tomography (CT) scan for evaluation5-7, but none outlined the exact three-dimensional anatomy of the ossicle. A detailed follow-up has not been provided on any of the prior patients.

The term talus bipartitus describes a large, separate piece of bone that constitutes about one-third of the posterior aspect of the talar body and is separated from that structure by a frontal split. A talus bipartitus is therefore considerably larger than an os trigonum, which contains part of the lateral tubercle of the posterior process of the talus. The os trigonum is not uncommon, with a calculated prevalence of 7% to 13%8,9.

Over a period of ten years, we have observed four young adult patients with radiographic findings of talus bipartitus. The clinical and radiographic findings were different in all four cases, and treatment consequently had to be tailored individually.

This is the first case series of this rare anatomic variant, and we report for the first time on the three-dimensional appearance of this separate ossicle. An average follow-up of 2.5 years after treatment was obtained. The patients were informed that data concerning the cases would be submitted for publication, and they all consented.

Case Reports

Case 1. A thirty-one-year-old woman presented with a fourteen-month history of occasional pain in the right ankle. She had a history of repetitive inversion sprains of both …

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