The Ankle and Foot Flashcards
What type of joint is the ankle?
Hinge-type
What are the ligaments of the ankle?
Lateral ligament - anterior talofibular, posterior talofibular, calcaenofibular
Medial ligament (deltoid): tibionavicular, tibiocalcaneal, anterior and posterior tibiotalar
Which muscles are responsible for dorsiflexion of the foot (4) and what are these innervated by?
TA
EDL
EHL
FT (slightly)
Innervated by deep fibular/peroneal nerve
Which muscles are responsible for plantarflexion (6) of the foot and what are these innervated by?
Gastrocnemius Soleus (Plantaris) FHL FDL Tibialis posterior
Innervated by tibial nerve
What are the 3 major ligaments of the foot?
Plantar calcaneonavicular
Long plantar
Plantar calcaneocuboid
What is the medial longitudinal arch of the foot composed of?
Talus, calcaneus, navicular, 3x cuneiform, 3x metatarsals
What is the lateral longitudinal arch of the foot composed of?
Calcaneus, cuboid, lateral 2 metatarsals
What is the transverse arch of the foot composed of?
Cuboid, 3x cuneiforms
Which is weaker - the lateral or the medial ligaments of the ankle?
Lateral - more prone to sprain.
Which X-ray views of the ankle would you order if you suspect an ankle injury?
- AP
- Lateral
- Mortise - ankle at 15 degrees of internal rotation, which gives true view of ankle joint and shows a symmetric joint space with no talar tilt
What are the Ottawa Ankle Rules?
Guides use of X-ray in emergency for potential ankle injuries
X-rays are only required if:
Pain in the malleolar zone AND
bony tenderness over the posterior aspect of the medial or lateral malleolus
OR
inability to weight bear both immediately after injury and in the ER
In addition to an X-ray, what other investigation would be ordered in an ankle injury to better characterize fractures?
CT
What is the Danis-Weber classification of ankle fractures based on?
Level of fibular fracture relative to syndesmosis
Describe a Danis-Weber Type A (2). What is it caused by?
Infra-syndesmotic
Caused by a pure inversion injury -
- Avulsion of lateral malleolus OR torn calcaneofibular ligament
- +/- shear fracture of medial malleolus
How is a Danis-Weber Type A fracture managed?
Most Type A #s are stable/non-displaced - minimal splintage (firm bandage or stirrup brace applied mainly for comfort)
Occasionally displaced requires ORIF + post-operative removable splintage boot for 6 weeks