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foot and ankle functional anatomy pt 2 - Coggle Diagram
foot and ankle functional anatomy pt 2
-choparts joint-TN and CC (midtarsal joint)
-lisfranc joint-3 cuneiforms and 4 and 5th MT (tarsometatarsal joint)
weightbearing surface of talus following syndesmotic injury
-1 mm lateral shift of talus results in 40% of weightbearing surface
-3 mm >60%
-5mm~80%
-arthritic changes possible
why is ankle susceptible to ant impingement?
-due to ant talus being wider (2.5 mm) in DF space os decreased
-can be further compromised by osteophytes, scar tissue and ORIF to syndesmosis
sinus tarsi-funnel shapred opening bw talus and calcaneous
-seperates ant/middle facets from post facet
-tarsal canal contains the talocalcaneal ligament and major blood supply to body of talus
tarsal tunnel
Tom, DIck, And Very Nervous Harry
-superficial to deep
post tib, FDL, artery, vein nerve (tibial), and FHL
bound by medial malleolus ant and achilles tendon post and roofed by flexor retinaculum
nerves that supply motor and sensory fibers to foot
-sural (posterolaterally)
-superficial peroneal (anterolaterally)
-deep peroneal (anteriorally)
-saphenous nerve (anteromedially, continuation of femoral nerve)
-post tibial (posteromedially, splits into medial/lateral plantar
porta pedis
-opening in plantar aspect of foot beneath belly of abd hallucis
-can get compressed and cause heel pain
-medial and lateral plantar nerves pass through here
Freshman's nerve
plantaris tendon
accessory bone-small ossicle that separates from normal bone
-os trigonum from post talus
-tibiale externum from navicular
-bipartite medial cuneiform
os vesalianum pedis base of 5th MT
os sustentaculo
sesmoids
-help transfer load through soft tissue to MT
-inc MA for FHB m
master knot of henry
fibrous band on plantar aspect of foot that adjoins FDL and FHL
effect of increased hallux valgus on PF strength at toe off
-40 deg decreases PF strength by 78%, 30 deg pronation deformity decreases to 5% of normal
Toygar's triangle
-lateral radiograph
-hypodense triangle bordered by the achilles posteriorly, sup border of calcaneous, and post border of mid to distal tibia
-lack of appearance on radiograph may be due to accumulation of fluid along tarsal tunnel
compressive forces of ankle
-walking 1-1.2x BW
-running 2x
-jumping 4-5x from height of 24 in
metatarsus adductus
-forefoot adduction and varus usually associated with intrauterine position
-"kidney bean" deformity
-most often resolves overtime
interossei/lumbrical function
-PF of MTPs and extension of IPs
functional anatomy of ATFL
-less dense at fibular attachment
-fibrocartilage is more prominent
-bone is more dense at talus and fibrocartilage character of ligament near talus dissipates forces
midfoot arthrosis
-sufferers have significantly higher ratio of 2nd MT length to 1st MT length
18.6% vs 4.1%