Ankle and Foot Flashcards
Rearfoot (hindfoot)
-talus
-calcaneus
Midfoot
-navicular
-cuboid
-cuneiform
Forefoot
-metatarsals
-phalanges
Foot Motions
Talocrual: DF/PF
Subtalar: INV/EV and ABD/ADD
Toes: flx/ext
Pronation: DF/EV/abd
Supination: PF/IV/add
Hindfoot: Calcaneovalgus/Calcaneovarus
Proximal Tibiofibular Joint
-head of fib and posterolateal tib
-convex tiba and concave fibula
-functionally ankle, anatomically knee
-hypermobility can lead to common fib injury
-inv trauma can lock proximal
Distal Tibiofibular Joint
-syndesmosis union
-ligaments only, no capsule
-injury at syndesmosis can lead to widening of mortise and instability at talocrual
Mortise
-talus in socket of distal tibiofibular joint
Talocrural Joint
-synovial hinge joint
-distal fib/tib on body on talus
-inclined lat 14deg, post 23deg, toe out 20deg
Proximal: Mortise= concave tibia + malleoi
Distal: talus on trochlear surface
Medial Collateral LIg
-deltoid lig
-fan shaped at navicular, talus, and calcaneus
-strong, not injured often (EV injury)
Lateral Collateral Lig
-anterior and posterior talofibular lig
-calcaneofibular lig
-limits inv
-weaker, commonly injured
Dorsiflexion at Talocrural J
Head of talus rolls dorsally and body of talus glides plantarly
-medial rotation
-20deg
-Closed packed, limited by gastroc/soleus
Plantarflexion at Talocrural J
Head of talus and body move oppositely, head rolls plantarly and body of talus glides dorsally
-lateral rotation
-50deg
-small amounts of ABD/ADD or EV/INV
-Loose packed, limited by ant tibialis
Talus Shape
-wider distally than proximally
-lateral facet is larger than medially
Subtalar Joint
-Talus and calcaneus
-alternating convex/convave improves stability
-42deg dorsally, 16deg medially
Proximal: concave talus on convex calcaneus, largest facet
Distal and Medial: convex facet on inferior body and neck of talus on concave facets on calcaneus
Distalmedial <> Proximallateral for mobilizations
-non communicating joint cavities
Tarsal Canal
-sinus tarsi: lateral
-Sustentaculum tali: medial
Subtalar Ligs
-Calcaneuofibular Lig
-ant/post Talofibular ligs
-interoosseous lig
-cervical lig (strongest)
-deltoid lig
Subtalar Motion
NWB:
-NWB Supination:calcaneal ADD/INV/PF
-NWB Pronation: calcaneal ABD/EV/DF
WB: calcaneus fixed able to move EV/INV only
-WB Pronation: calcaneal EV, talar ADD/PF, tib/fib MR (open packed)
-WB Supination: calcaneal INV, talar ABD/DF, tib/fib LR (closed packed)
Subtalar ROM
Calcaneal INV: 20-30
Calcaneal EV: 5-10
Bilateral stance: 3-5 EV
Heel strike: 3 INV then EV
Push off: 5.5 INV
Transverse Tarsal Joint
-Talonavicular and calcaneocuboid (immobile)
-divides hindfoot and midfoot
-linked to subtalar in WB during Sup/pron
-25 degrees from ground
Talonavicular Joint
-distal convex head of talus and concave proximal navicular
Talonavicular Joint Ligs
-Spring lig: from sustentaculum tali on calcaneus to navicular, sling too hold head of talus
-Deltoid ligaments reinforce
-Bifurcate lig laterally
Calcaneocuboid Joint
-distal calcaneus and proximal cuboid
-reciprocal concave/convex restricta mmt
Calcaneocuboid Joint Lig
-Bifurcate lig
-Dorsal and long plantar calcaneocuboid ligs
Weightbearing Supination
Tibial ER < hindfoot sup < talus and calc drag navicular and cuboid into sup
