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Ankle Injury Management. Module J2. Bones and Prominent Boney Features. Calcaneus Talus Cuboid Navicular Cuneiforms Tibia Fibula. Articulations. Ankle Mortice
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Ankle Injury Management Module J2
Bones and Prominent Boney Features • Calcaneus • Talus • Cuboid • Navicular • Cuneiforms • Tibia • Fibula
Articulations • Ankle Mortice • Distal Tibiofibular- is a fibrous articulation. It is between the lateral malleolus and the distal end of the tibia. Reinforced by ankle ligaments • Subtalar- Consists of the articulation between the talus and the calcaneous. • Transverse Tarsal
Ligaments • Anterior/posterior tibiofibular- (aka syndesmotic ligaments) • Calcaneofibular- • Anterior talofibular • Deltoid • Peroneal retinaculum
Ant. Tibialis Flexor hallicus longus Flexor digitorum longus Posterior tibialis Extensor hallicus longus Extensor digitorum longus Peroneus longus Peroneus brevis Peroneus tertius Gastrocnemius Soleus Muscles
Other structures • Anterior tibial artery • Deep peroneal n. • Superficial peroneal n • Posterior tibial n.
Anterior Drawer Test • Used to determine the extent of an injury to the ATF ligament primarily and the other lateral ligaments secondarily. • Have athlete sit on the edge of a treatment table • ATC grasps the lower tibia in 1 hand and the calcaneus in the palm of the other • Tibia is then pushed backward as the calcaneus is pushed forward • Positive sign= the foot slides forward, sometimes making a clunking sound as it reaches its end point. Generally indicates a tear in the ATF
Talar Tilt test • Used to determine the extent of inversion or eversion injuries • Foot positioned at 90° to the lower leg and stabilized, the calcaneus is inverted • Excessive motion of the talus indicates injury to the CF and possibly the ant/posterior talofibular ligaments as well
Kleiger’s test • Used primarily to determine injury to the deltoid ligament. It can also, however, indicate injury to structures that support the distal ankle syndesmosis, including the ant/posterior tibiofibular ligaments and the interosseous membrane • Athlete should be seated with legs over the table • One hand stabilizes the lower leg while the other holds the medial aspect of the foot • Rotate laterally • Pain over the deltoid ligament indicates injury, and pain over the lateral malleolus indicates injury to the syndesmosis
Tap test • Tinel’s sign • Malleolus fx
1st° ankle 2nd° ankle 3rd° ankle Sprain- dislocation Anterior tibial strain Peroneal strain Fracture Stress fracture Avulsion fracture Injuries and Conditions
The End Questions???