ankle Flashcards
subtalar rom
inversion 0-5
eversion 0-5
talocrural ankle rom
PF 50
DF 20
talocrural open pack
10 PF
talocrural closed pack
full DF
midtarsal, transverse tarsal, chopart rom
inversion 35
eversion 15
pathology?
- Partial tear of the lateral ligament complex with mild joint instability,
- moderate intra- capsular swelling and tenderness,
- some loss of ROM and joint function
moderate Grade II right lateral ankle sprain
pathology?
- Complete rupture of the anterior talofibular ligament, calcaneofibular ligament, and capsule with mechanical joint instability;
- severe intra/extra-capsular swelling, ecchymosis,
- tenderness
- inability to weight-bear.
severe or Grade III lateral ankle sprain
pathology?
- Stretch of the lateral ligament complex with no macroscopic tear or joint instability,
- little swelling or tenderness
mild or Grade I lateral ankle sprain
pathology?
- Partial tear of the syndesmosis,
- creating generalized swelling and tenderness throughout the ankle joint complex;
- inability to bear weight,
- severe ecchymosis,
- mortise widening.
high ankle sprain, Syndesmosis sprain
purpose?
Talar tilt test
ankle inversion stress test
torn calcaneofibular ligament, inversion sprain
resists inversion of the talus within the midrange of talocrural motion
purpose?
Anterior drawer test
sprain of the anterior talofibular ligament, inversion sprain
- resists inversion of the talus and calcaneus and is taut during plantar flexion.
purpose?
Ottowa rules
rule out fracture and is used as a common screening
what test? purpose?
Patient prone and asked to relax as the therapist squeezes the muscle bellies of the gastrocnemius and soleus.
Positive: absence of plantar flexion.
Thompson Test
Achilles tendon rupture.
DF needed for gait, what phase?
10deg DF for midstance
PF needed for gait, what phase?
20deg PF
preswing (pushoff)
purpose?
ankle eversion stress test
deltoid ligament integrity
purpose?
posterior drawer test on ankle
posterior talofibular ligament
- resists posterior translation of the talus and is the strongest of the lateral ligaments
pathology?
- due to excessive eversion forces with the ankle in plantar flexion, dorsiflexion or neutral.
- frequently accompanied by an avulsion fracture of the distal tibia.
medial ankle sprains - deltoid ligament
risk factors achilles tendon rupture?
- males
- between the ages of 30 and 50
- who exercise inconsistently (e.g., “weekend warriors”).
- Racquet sports, basketball, agility sports - requires frequent and sudden changes in direction as well as rapid acceleration.
what test? purpose?
Patient supine, actively extend his knee.
Once the knee is extended the examiner raises the patient’s straight leg to 10 degrees, then passively and abruptly dorsiflexes the foot and squeezes the calf with the other hand.
Positive: Deep calf pain and tenderness may indicate
Homans’ sign - detection of a deep vein thrombosis in the lower leg.
The test lacks specificity and therefore a positive finding cannot be considered conclusive without the use of more formal diagnostic tests.
what pathology?
- serious medical condition that causes compression of nerves and blood vessels in an anatomical space (eg. anterior leg).
- dangerous disruption of nerve conduction and blood flow that can threaten the viability of the limb.
- Symptoms include severe, unyielding pain in the affected area as well as a tight, shiny skin appearance, and weakness.
- associated with a trauma that has occurred in the area of the complaint.
Compartment syndrome
talocrural joint motions?
movement with supination and pronation?
DF, PF
talocrural joint
- laterally (externally) rotates with supination
- IR with pronation
Ottawa Ankle Rules
need radiograph if
pain present in the malleolar zone AND ANY ONE of the following are present:
Bone tenderness along the distal 6 cm of the posterior edge of the tibia or tip of the medial malleolus
OR
Bone tenderness along the distal 6 cm of the posterior edge of the fibula or tip of the lateral malleolus
OR
An inability to bear weight both immediately and in the emergency department for four steps
