Ankle Flashcards
Talus is thicker
Anteriorly
Pronation includes
DF
ABD
EV
Supination includes
PF
ADD
INV
Gravity has tendency to
force us into anterior fall
PF (gastroc/soleus) control this tonically
Supination twist
WB as go into heel strike Calc everts (so forefoot supinates) Plantar ligaments tighten Talus ADD IR of tibia
Subtalar joint is what
Talus with calcaneus
ROM
50
20
20 (inv)
10 (ev)
Windlass effect
Plantar fascia from calcaneus to first row of phalanges
When you DF you foot, you would think the arch would be flat because fascia tight - BUT actually the arch becomes caves because of DF and aponeurosis inc cavus!
Windlass test - big toe extension
3 arches of the foot
medial and lateral and 1 transverse
Trans - intermed cuneiform
Med - talus and navicular
Lat - cuboid
Add strength, stability, mobility, resilience
Shock absorption, dissipate energy
Ottawa ankle rules
Inability to WB 4 steps after
Bony tenderness to posterior malleoli edge
Bony tenderness 6cm above either malloelus
Bony tenderness at navicular
Bony tenderness over base of 5th MT
At initial contact, what does the calcaneus do?
Calc EV
Rearfoot pronation
At push off - calc does what
Calc INV
Rearfoot supination
When calc evers, the tibia
IR
When calc inverts, the tibia
ER
NWB forefoot is in varus, in WB the forefoot will
Pronate
Calc EV
Tibia IR
Because IR tibia is coupled with knee FLEX, this will cause a knee flexion moment at the knee and IR at the hip
NWB calc valgus, WB calcaneus
continues in valgus (like eversion of calcaneus)
forefoot supinates
tibia IR
talus add
NWB calc varus, WB calcaneus
continues in varus (like inversion of calc)
forefoot pronates
tibia ER
talus abd
When testing DF ROM - important to
bend knee so that gastroc is shortened
Achilles tendinopathy
Occurs 3-6 cm above insertion
Mulders sign
Testing for mortons neuroma
Common between 3rd and 4th
Kliegers test
Deltoid ligament
for high ankle sprain
Anterior drawer test
for anterior talofibular
ankle is in 10-15 degrees of PF
Posterior drawer test
Posterior tibiofibular ligament
Push talus post
Tarsal tunnel syndrome
Post tibial nerve compression at flexor retinaculum
Thompson test
squeeze gastroc (+) if no PF
Calcaneofibular ligament test
Stab tib/fib
DF to 90
And place force into inversion
Posterior talofibular test
Stabilize tib/fib
Rotate heel medially with DF
Deltoid
Bring entire foot over laterally to stress medial strcutrues
Squueze
Squeeze 6-8in below the knee - syndesmosis lesion
Sustentaculum tali
Tom, Dick, and nervous Harry (MEDIAL)
TP, FDL, tibial artery, tibial nerve, FHL
Ankle ligament testing (ones with order)
Anterior drawer (ant talofibular ligament)
Calcaneofibular ligament test
Posterior talofibular ligament test
If A is neg don’t do C, if C is neg don’t do P
Lateral collateral ligaments includes
Talofibular (ant and post)
Calcaneofibular
Medial ligaments
Deltoid
Spring
Which is weaker - medial or lateral ankle
Lateral!
Wells criteria DVT
need 3 major and 2 min
Active CA, Paralysis, Bedridden, Tenderness, Thigh/Calf Swelling, Family hx of DVT
Hx of recent trauma, Pitting edema, Dilated Sup Vens, Hospitalized last 6 months, Erythema
