ankle and foot anatomy Flashcards
Name the lateral ligaments of the ankle?
Which is the strongest and weakest?
- Anterior talofibular ligament
- Calcaneofibular ligament
- Posterior talofibular ligament
- Syndesmosis includes- AITFL, PITFL, TTFL, IOL, ITL
- Ant talofibular -weakest
- Post talofibular lig - strongest
Name the medial ankle ligaments?
- Deltoid
- Calcaneonavicular ligament - Spring ligament
What is the main stabiliser in stance phase of gait ?
Deltoid ligament
What is the deltoid ligament made up of?
- Deep and superficial ligaments
-
Superficial
- crosses both ankle and subtalar joints
- tibiocalcaneal ( sustenaculum portion ) is strongest portion in superificial layer and resists calcaneal eversion
-
Deep
- only crosses ankle joint
- primary stabiliser of medial ankle
- prevent lateral displacement & external rotation of talus
- originates inferior and posterior aspects of medial malleolus and inserts medial adn posterolateral aspects of talus and inserts medial posteromedial aspects of talus
How do you test the deltoid ligament?
- eversion test
- with ankle in neutral , evaluates superificial layer
- external rotation stres test evaluates syndesmosis and deep layer
What investigations is helpful to dx deltoid lig injury?
Xray
- Mortice view with medial clear space widening
- Gravity stress view
MRI
- rutured Deltoid ligament
What is the function of the spring ligament?
- Static stabiliser of the medial longitudinal arch and head of talus
Describe the anatomy of the spring ligament- Calcaneonavicular?
- Attaches from sustentaculum tali to inferior aspect of navicular
What is seen clliniclly in a pt with spring lig injury?
- Flattening of medial longitudinal arch
- s_uspect injury in associated posterior tibial tendon patholog_y
What investigations are useful in dx of spring ligament injury?
MRI
- can dx tear
- green on pic normal , red is torn
- spring ligament ca be torn is association of tibialis posterior insufficiency or an acute tear with intact TP
What is the function of the syndesmosis?
what is the syndemosis made up of?
- intregrity of ankle mortice
anatomy
- Anterior- inferior tibiofibular ligament (AITFL)
- posterior- inferior tibiofibular ligmament (PITFL)
- Transverse tibiofibular ligament (TTFL)
- Interosseous ligament (IOL)
What is the imaging useful for DX a syndemotic injury?
Xarys
- Ap and mortise ankle radiographs
- evaluate the clear space adn tibiofibular overlap
- tibiofibular clear space should be <5mm
- Tibiofibular overlap for AP view >10mm
- WB mortise view most accurate to dx
CT scan
- Most accurate assessment
What bones comprise the hindfoot ?
Talus Calcaneus Cuboid
What joints make up the hindfoot ?
Subtalar Calcaneocuboid Talobavicular