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2/02/2015

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Leg, Ankle and Foot Joints

PHTY100 Physiotherapy Anatomy 1 MS

Tibiofibular joints
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 three joints:
 superior tibiofibular joint
 synovial, mulitaxial, plane
 small range glides in each of the major
planes
 intermediate tibiofibular joint
 fibrous (a syndesmosis)
 interosseus membrane
 long fibres  v. small movt.
 inferior tibiofibular joint
 fibrous (a syndesmosis)
 short fibres  v.v.v. small movt.

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Inferior Tibiofibular joint


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 anterior and posterior


tibiofibular ligament –
parallel to one another i.e.
fibres run downward and
laterally

anterior talofibular ligament

Tibiofibular joints
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 movements at the ankle result in


shifts in position of the fibula
 moves upward and rotates when
ankle in dorsiflexion – very small
range movts
 the synovial superior tibiofibular
joint allows these movements to be
accommodated

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Bones of the foot


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axis of the foot

phalanges – proximal, middle and distal

metatarsals

medial, intermediate and lateral cuneiforms


navicular
cuboid TARSALS
talus
T
calcaneus
mC N
C
Right foot, inferior view Plantar surface

Ankle (talocrural) joint


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 classification
 synovial, uniaxial, hinge
 movements
 dorsiflexion 30° plantarflexion 50°
 transverse axis

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Articular surfaces
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 tibia – female surface

Left tib and fib- posterior and inferior views

 inferior (trochlear) surface of the tibia


 medial (tibial) and lateral (fibular) articular facets

Articular surfaces
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 talus – male surface

 trochlear of the talus – wider anteriorly


 as ankle moves into dorsiflexion it becomes more
stable
 medial and lateral articular facets are non-weightbearing
Left tarsals from above

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Articular structures
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 joint capsule
 as expected, attaches to the articular margins of the
bones involved
 more extensive anteriorly where it extends onto the
neck of the talus
 collateral ligaments provide medial and lateral
reinforcement to the capsule

Ligaments
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 medial collateral (deltoid) ligament


 extensive, triangular in shape
 superficial parts
T
 tibionavicular
PostTT
 tibiocalcaneal AntTT
 together prevent abduction at ankle
 deep parts N
C
 anterior tibiotalar
 limit plantarflexion
Right ankle, medial view
 posterior tibiotalar
 limit dorisflexion

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Ligaments
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 lateral collateral ligaments


 three separate bands PostTF
 anterior talofibular AntTF
 limits plantarflexion F
 prevents posterior slide of tib and fib on talus
 posterior talofibular N
 limits dorsiflexion C
 prevents anterior slide of tib and fib on talus
 calcaneofibular
 limits dorsiflexion
 prevents adduction at ankle CalcFib

Joints between the tarsals


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 classification
 synovial, multiaxial
 movements
 inversion
 plantarflexion
Calcaneocuboid joint  adduction
 supination

Talcalcaneonavicular joint  eversion


 dorsiflexion
Subtalar joint  abduction
 pronation

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Significance of inversion and eversion


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 allows adjustment to uneven ground surfaces


 allows foot to be converted from rigid to flexible
 efficiency in gait

Subtalar joint
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 articular surfaces
 faceton under surface of the talus (female)
 posterior facet on upper surface of calcaneus (male)

 ligaments
 interosseus (talocalcaneal) ligament
 two bands both anterior to the joint
 run almost vertically in the space between talus and
calcaneus
 calcaneal parts of the ankle ligaments also cross this
joint

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Subtalar joint
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Left foot, lateral view Right foot, superior view,


talus removed

Subtalar joint

Talocalcaneal ligament occupies much of this space

Talcalcaneonavicular joint
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 articular surfaces
 anterior facet on upper surface of calcaneus (female)
 sometimes in two parts
 posteriorfacet of the navicular (female)
 plantar calcaneonavicular (spring) ligament

 head and (partially) neck of the talus (male)

L talus from below


L calcaneus and
navicular from above

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Talcalcaneonavicular joint
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 ligaments
 plantar calcaneonavicular (spring) ligament
 bifurcate ligament (medial part only)

Cub
N

Calc

Right foot, superior view,


talus removed

Calcaneocuboid joint
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 articular surfaces
 faceton anterior surface of calcaneus
 posterior facet of the cuboid

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Calcaneocuboid joint
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 ligaments
 plantar calcaneocuboid (short plantar) ligament
 long plantar ligament

 bifurcate ligament (lateral part only)

Right foot, superior view,


talus removed
Left foot, inferior view

Metatarsophalangeal joints
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 classification
 synovial, biaxial, condyloid
 movements
 flexionand extension
 abduction and adduction

 articular surfaces
 head of the metatarsal
 base of the adjacent phalanx

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Metatarsophalangeal joints
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 ligaments
 collateral ligaments
 limit
flexion
 prevent add and abd in flexion

 plantar ligaments
 forms part of the articular surface
 limits extension

 deep transverse metatarsal ligaments


 keeps the metatarsal heads together, particularly important
in weight bearing

Interphalangeal joints
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 classification
 synovial, uniaxial, hinge
 movements
 flexion and extension
 ligaments
 collateral ligaments
 limit flexion
 plantar ligaments
 limit extension

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