Ankle Flashcards
talocrural joint - which position is most stable? least stable?
DF most stable
PF least stable
Subtalar joint axis
superiorly 42 deg in sagittal plane
medially 16 deg
calcaneocuboid joint ligamentous support
long plantar ligament - one of the strongest in the body = minimal mvt at calcaneocuboid joint
talonavicular joint ligamentous support
plantar calcaneonavicular or spring ligament prevents excessive motion of navicular on the talar head - supporting medial longitudinal arch
midfoot locking theory
when hindfoot is pronated, the axes of the talonavicular and calcaneocuboid joints are parallel.
when inverted, the axes are not parallel = rigid lever for a foot
surgical release of the plantar fascia likely leads to failure of what ligament?
spring ligament - 2/2 a 94% increased load. There is also a 52% inc in long plantar lig load
plantar fascia is crucial to maintaining what arch?
medial longitudinal arch
Anterior drawer test
laxity or tear in ATFL if pain in lateral anterior ankle or forward translation >3mm
talar tilt test
done in 20 deg PF - biases ATFL
done in 10 deg DF - biases CFL
positive = pain or 15 deg more on involved side
questionable reliability
ER test of the ankle
knee in 90 deg, ER foot and ankle.
pain = syndesmosis
thompson test
prone, knee flexed to 90 deg, squeeze the calf, ankle should PF if no achilles rupture (complete or partial)
windlass test
passively move 1st MTP into DF.
pain reproduction along plantar fascia = plantar fasciitis
high specificity 0.99
low sensitivity 0.33
mulder click test
for neuroma, push mass between met heads with thumb and squeeze.
if there’s a click and pain with the mass being pushed plantarly, it’s likely a neuroma
Tinel for posterior tibial n
tap along medial ankle from medial longitudinal arch to above medial malleolus
Flat foot posture - kids lose this around what age?
12-13yo
