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Ankle
Consist of
3 bones (ankle)
26 bones (foot)
34 joints
Functions
Shock absorption
Bones
Calcaneus
1st to ossify
MC Fx
(+)sustentaculum tali
Talus
TB of the foot
No (M) attachment
Metatarsals
2nd MT (shaft)
2nd MT (head)
5th MT (base)
2>3>1>4>5
Egyptian foot
Squared foot
Palpable structures
Sustentaculum tali
Deltoid Lig
Tuberosity of the
navicular
First cuneiform
First TMT jt
First MT
First MTP jt
Talus
Calcaneus
Cuboid
Arches
2 longitudinal
1 transverse
MLA
Contents
Calcaneus
Talus (keystone)
Navicular
Cuneiform
1,2 ,3 MT
LLA
Contents
Calcaneus
Cuboid (keystone)
TA
Cuboid
3 cuneiform(2nd keystone)
Base of all MT
Supporting structures of
the arches
MLA
LLA
Ligament
Spring/Plantar
Calcaneonavicular
Ligament
Tendon
Tibialis Posterior
Tendon
Peroneus Longus
Talocrural joint
Ligaments
CalcaneoTibial Lig
TibioNavicular Lig
OPP: 10 PF
CPP: Max DF
CP:PF>DF
TibialTorsion
(N) 20 to 23
Triplanar Motion
Supination
Inversion
Plantarflexion
Adduction
Pronation
Eversion
Dorsiflexion
Abduction
Subtalar joint
Talocalcaneal joint
Midtarsal joint
Talonavicular joint
Calcaneocuboid joint
Tarsometatarsal Joint
Metatarsophalangeal
Joints
condyloid synovial joints with 2 of freedom:
flex/ext, add/ abd
metatarsal heads are convex and the prox.
phalangeals are concave.
second metatarsal is longer than the rest making the
2nd MTP more ant.
30
90
10 from 2nd metatarsal
long axis throught the metatarsal
Position of reference and phalangeal bones in a straight
line
Resting position
slight extension
full extension
Interphalangeal joints
synovial hinge (modified sellar) with one degree
of freedom
5 prox interphalangeal joint and 4 distal
interphalangeal joints.
Flex ROM
90 PIP, 40 DIP
resting position
closed packed
position
slight flexion
Full flexion
Important Landmarks
Popliteal Fossa
Tarsal Tunnel
Tibialis Posterior
FDL
FHL
Extensor Retinaculum
Tibialis anterior
EHL
Tibial A, V
EDL
PT
Blood Supply
Femoral Artery
Popliteal Artery
Lat to TA
Lat to EHL
Anterior
TA
EDL
EHL
PT
Posterior
Superficial
Gastronemius
Soleus
Plantaris
Deep
Tbialis Posterior
FDL
FHL
Popliteus
Lateral
PL
PB
Foot Muscles
Dorsal
EDB
Plantar
Abd Hallucis
Lumbricals
Adductor Hallucis
EDB
Abd Hallucis
FHB
Abd Hallucis
1st Lumbrical
FDB
Foot Conditions
Equinus
Calcaneus
Valgus
Varus
Classes of Conditions
> Traumatic surgical intervention
non surgical intervention
Insidious onset
Congenital
Traumatic
Fractures Ankle
Mid foot
Forefoot
Posterior Tibialis
Peroneal
ORIF
ORIF
ORIF
OREF (Hoffman)
Immobilization
Repair
MRI
Immobilization
Amputation
Lysfranc- tarsometatarsal
Tendinosis
Stress fractures
Hammer toes
Metatarsalgia
Neuromas
Plantar Fascitis
Compartment Syndrome
Peroneal Tendons
Medial Tendons
Tendinitis
(post. tib., achilles, peroneal)
warm
Treatment
Relative rest
Ice 15
Ankle Sprains
Lateral (ATF+CF)(85%)
Medial (Deltoid)>
High (Syndesmosis)>
Mid tarsal
Possible causes:
Ankle Ligaments
Midtarsal Sprain
Treatment
Surgery?
RICE
Progressive WB
Plantar Fascitis
Causes
Windlass Mechanism
Windlass Mechanism
toe extension during propulsion, puts tension
on the plantar fascia and passively raises the
arch.
Body weight
Plantar fascia
GRF
GRF
Treatment
Bunions
(Hallux Valgus)
Bunions
Forefoot varus
Treatment
Strengthening
Treatment
stretching
orthotics
Tibia
Calcaneal
Calcaneal
Femur
Stress Fractures
Probable Causes
Distance running
Gymnastics
Dance
Metatarsalgia
Treatment
Treatment
Neuromas
Treatment
Calcaneal Apophypisis
Male Adolescence
Severs Dse
Hoglands Dse
Self limiting
Osteo arthritis
Radiography