Lecture 2 - Midtarsal Joint Flashcards by Joey Wilson

Talonavicular joint

Calcaneocuboid joint

Chopart’s Joint

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15˚ from transverse plane and 9˚ from sagittal plane

Longitudinal axis (LA)

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Axis with primarily frontal plane motion

Inversion and eversion

Longitudinal axis (LA)

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52˚ from transverse plane and 57˚ from sagittal plane

Oblique axis (OA)

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Axis with primary motion
Plantarflexion with adduction (pad)
Dorsiflexion with abduction (dab)

Oblique axis (OA)

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Allows foot to adapt to subtalar joint variations

Longitudinal Axis

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Allows foot to remain plantargrade

Longitudinal Axis

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“secondary ankle joint”

Oblique axis can compensate for lack of ankle _________

Dorsiflexion

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STJ to MTJ relationship

STJ pronation–> Midtarsal joint becomes more ____ becasue it becomes unlocked. This allows the foot to become mobile adapter

Parallel

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Supinated STJ –> MTJ?

MTJ axes cross

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The ________position of the MTJ is the stable position of the MTJ

Pronated ( When it is locked)

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The ________ position of the MTJ is the unstable position of the MTJ

Supinated

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Pronated MTJ

Calcaneocuboid joint _______

Dorsiflexes

Ligaments tighten, preventing excessive motion

Supinated MTJ
- Ligaments will also tighten in this position
Bones, however, are not tightly packed
Osseous locking not present

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Locking of MTJ

pushing up on the heads of the 4th and 5th =

Simulates weight bearing

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Open Kinetic Chain

Contact period of gait
OA?

OA – pronated
Extensor digitorum longus and peroneus tertius contracted
Dorsiflexion and abduction

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Open Kinetic Chain

Contact period of gait
LA?

LA – supinated
Anterior tibialis muscle contracted
Inversion

Open Kinetic Chain

Contact period of gait

STJ ____allowing shock absorption

Pronating

Closed Kinetic Chain

Midstance

OA?

OA – pronated

Dorsiflexed and abducted

Closed Kinetic Chain

Midstance

LA?

LA – pronated
Begins to evert in reaction to STJ supination
Helps to “lock” the MTJ to become rigid lever

Closed Kinetic Chain

Midstance

STJ?

STJ – supinating

In preparation for propulsion

Closed Kinetic Chain

Propulsion

OA?

OA – Supinated

Windlass mechanism aids in this along with contraction of intrinsics

Closed Kinetic Chain

Propulsion

LA?

LA – pronated

Locking still present at cc joint

Closed Kinetic Chain

Propulsion

STJ?

STJ - Supinated

_______is a pulley device to lift a heavy object

Windlass

The metatarsal heads are the pulley mechanism

Summary - STJ Contact Midstance Propulsion

Pronation Supination Supination -- LA is always opposite of STJ

Summary - LA Contact Midstance Propulsion

Supination Pronation Pronation

Summary - OA Contact Midstance Propulsion

Pronation Pronation Supination

MTJ ROM is passively controlled by position of the ____

STJ STJ supination causes Decrease in MTJ ROM STJ pronation causes Increase in MTJ ROM

Anterior Tibial muscle ____the longitudinal axis

Inverts | - decelerate the foot at heel strike to prevent foot slap

Peroneus tertius and extensor digitorum longus _____ the oblique axis

Pronate - decelerate the foot at heel strike to prevent foot slap

Measuring forefoot to rearfoot relationship

Prone --> STJ neutral --> Push on 4th and 5th --> Evaluate if plantar heel is parallel with metatarsal head -- Look at powerpoint

Forefoot varus greater than calcaneal eversion available | Calcaneus is unable to evert past neutral

Uncompensated forefoot varus

Forefoot varus greater than calcaneal eversion available Calcaneus able to evert past neutral but not to same degree of FF varus Additional compensation gained through oblique axis MTJ, and 1st ray

Partially compensated forefoot varus

Forefoot varus equal or less than available calcaneal eversion

Compensated forefoot varus

Forefoot Valgus Longitudinal axis ______ Subtalar _____ Oblique axis ______ Further Subtalar ______

supination LASOS --> Long Axis, Sub, Oblique, Further sub Order of formation

if only Longitudinal axis compensation | Heel remains vertical but foot unstable in midstance due to midfoot supination

Flexible deformity

If STJ or OA compensation needed | Heel will be ______

Rigid deformity Inverted