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Foot and Ankle Biomechanics
Foot and Ankle Biomechanics
Talocrural Joint
• Talus is convex AP
Supination Pronation
Combined motion consisting of Combined motion consisting of:
• talocrural plantar flexion • talocrural dorsiflexion,
• mid/forefoot adduction • mid/forefoot abduction
• subtalar inversion • subtalar eversion
Arthrokinematics subtalar joint
Open chain
• In supination the calcaneus moves medially and inverts
Closed chain
• Pronation consists of tibial IR, talar plantar flexion/adduction and calcaneal eversion
•Talonavicular joint
•Cubonavicular joint
•Cuneonavicular joint
•Intercuneiform joints
Tarsometatarsal joints
Joints between the distal row of tarsals and the proximal row of the proximal
metatarsals
• MT 1 articulates with medial cuneiform. Very lax joint capsule. First ray takes
care of 60% of the weightbearing. The subsequent rays are responsible for
10% each
Sesamoid function:
•Protect FHL tendon from weightbearing trauma as it passes through the tunnel formed by
sesamoids and intersesamoidal ligament
Metatarsalphalangeal joints
ROM MTP I extension 70 degrees (60 required for normal gait)
flexion 45 degrees
Arthrokinematics
Dorsiflexion
•Increased distance between medial and lateral malleolus, which tightens
interosseous membrane
•Fibula externally rotates (due to the wedge shape of the talus) and glides
superior
Plantar flexion
•Decreased distance between medial/lateral malleolus
•Fibula glides inferiorly and internally rotates
Sources of stability
• Transverse arch
• Ligamentous support
•PT’s using CPR’s should also bear in mind that the rules also
apply to acute first time presentations of significant injuries
Ottawa Ankle Rules
Ankle
•Pain in the malleolar area and tenderness over the posterior edge or tip of the
lateral or medial malleolus
•Unable to bear weight immediately and on examination.
Foot
•Pain in the midfoot region, tenderness of base 5th metatarsal or navicular bone
•Unable to bear weight immediately and on examination
•Tibia
•Calcaneus
•Talus
•Cuboid
•First metatarsal
•Navicular
Ankle Trauma
In adults the ankle is the most frequently injured major joint in the body
Ankle radiographs are among the most frequently ordered studies in the ER
department
However, only a small percentage of these patients will have a fracture that
requires definition by radiography
1. Medial malleolus
2. Sustentaculum talus
3. Navicula tuberosity
4. First MT joint
5. Tibialis posterior
6. Tibialis anterior
1. Achilles tendon
3. Bursa
4. Fifth MT
6. Peroneus longus
7. Peroneus tertius