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Comprehensive Examination of the Foot and Ankle

Explore foot and ankle anatomy, key history points, hands-on exams, and common injuries. Learn gait analysis and evaluation techniques.

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Comprehensive Examination of the Foot and Ankle

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  1. EXAMINATION OF THEFOOT AND ANKLE Dr. Mohammed Zaheer Dalati Senior Registrar Department of Orthopaedics College of Medicine King Khalid University Hospital

  2. Objectives • Review anatomy of Foot and Ankle. • Discuss key history • Hands on exam • Discuss cases concerning common injuries of the Foot and Ankle

  3. Anatomy

  4. Anatomy

  5. Anatomy

  6. Anatomy

  7. Anatomy

  8. Anatomy

  9. Anatomy

  10. History • Onset • Duration • Mechanism • Swelling / Ecchymosis • Ambulation • Hx of previous injury

  11. 2 PARTS: 1- ERECT POSITION. 2-SUPINE POSITION.

  12. Inspection. Palpation. Movements. Special tests.

  13. INSPECTION OF THE PATIENT’S GAIT: Evaluation of the walking cycle GAIT ANALYSIS

  14. STANCE PHASE 65% • Contact Period - heel strike to forefoot loading • Midstance Period - forefoot loading to heel raise • Propulsive Period - heel raise to toe off • SWING PHASE 35%

  15. Stance phase GAIT ANALYSIS

  16. Trendelenburg gait

  17. Tip-toe walking

  18. Foot drop walking

  19. Spastic gait

  20. Intoeing/Out toeng gait

  21. Antalgic gait

  22. Inspection in standing position

  23. INSPECTION: POSTERIOR HEEL STANDING

  24. FOOT SHAPE

  25. ALL THE TOES SHOULD BE IN GROUND CONTACT IN W.B.(stability of the foot on the ground)

  26. INSPECTION: of the L.L Any asymmetry of length, rotational problem, or mal alignment of the lower limbs.

  27. INSPECTION: - Deformity, swelling, skin changes, muscle wasting, asymmetry of length, abnormal position…. INSPECT ALL ARROUND

  28. INSPECTION: PLANTAR SKIN callosity

  29. Palpation: Bone and joints Soft tissues

  30. Anatomical landmarks: -Medialmalleolus, lateral malleolus, Achilles tendon, calcaneal tuberosity, peroneal tendon, tibialis posterior tendon, tibialis anterior tendon, plantar fascia, base of 5th metatarsal, 1st MP joint, metatarsal heads……..etc

  31. PALPATION: Tenderness, swelling, deformity…. Knowing the anatomy:

  32. MOVEMENTS: Ankle: -dorsiflection -plantar flection. Subtalar: -inversion -eversion. Midtarsal: -pronation -supination Tarso-metatarsals: move the metatarsals one by one. Toes:

  33. Ankle movements:

  34. SUBTALAR: MOVEMENT: MOVE THE HEEL: Inversion---eversion

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