Chapter 108 - Anatomy and Biomechanics of the Foot and Ankle

Question 1

the lateral ankle ligament complex is composed of what three ligaments?

Answer 1

1. anterior talofibular ligament - runs from anterior aspect of distal fibula to the body of the talus
   - strained with plantar flexion, inversion, and internal rotation
2. calcaneofibular ligament - runs from the distal tip of the fibula to the lateral wall of the calcaneus
   - tight with dorsiflexion and inversion
3. posterior talofibuilar ligament - broadly on the posterior fibula to the posterolateral tubercle of the talus

Question 2

syndesmosis is composed of what three ligaments?

Answer 2

AITFL - anterior tibiofibular ligament
PITFL - posterior tibiofibular ligament
Interosseous ligament

Question 3

spring ligament is composed of what parts?

Answer 3

superior medial calcaneonavicular ligament
inferior calcaneonavicular ligament (deep and superficial)

Question 4

lis franc ligament complex

Answer 4

three layers
1. deep/plantar layer (2nd strongest)
2. interosseous layer - ligament running from the plantar surface of the medial cuneiform to the base of the 2nd metatarsal - this is the strongest layer, and called the actual lis franc ligament
3. superficial/dorsal layer (weakest)

Question 5

contents of the tarsal tunnel (from anteromedial to posterolateral)

Answer 5

from anteromedial to posterolateral
- posterior tibialis tendon
- flexor digitorum
- posterior tibial artery
- tibial nerve
- flexor hallucis longus

Question 6

peroneus brevis inserts where?

Answer 6

base of the 5th mt - accessory os in this tendon is called an os vesalianum

Question 7

os peroneum is where?

Answer 7

in the peroneus longus tendon

Question 8

posterior tibial artery bifurcates into what?

Answer 8

medial and lateral plantar arteries
- bifurcates below the sustentaculum

Question 9

anterior tibial artery turns into what?

Answer 9

dorsalis pedis artery

Question 10

blood supply to the talar body

Answer 10

retrograde via the artery of the tarsal canal

Question 11

blood supply to the talar head/neck

Answer 11

artery of the tarsal sinus

Question 12

inversion of the subtalar joint does what to the transverse tarsal joint?

Answer 12

locks it

Question 13

eversion of the subtalar joint does what to the transverse tarsal joint

Answer 13

unlocks it

Question 14

position of subtalar and tn joints during heel strike?

Answer 14

subtalar joint is everted, and the talonavicular joint is unlocked to accommocte heel strike

Question 15

position of subtalar and tn joints during push off?

Answer 15

subtalar joint is inverted, talonavicular joint is locked, providing rigid lever or push off

Question 16

nerves at risk during ankle arthroscopy:

Answer 16

• anterolateral portal - spn
• anteromedial portal - saphenous n
• direct anterior/anterior central - dpn
• posterolateral - sural
• posteromedial - tibia