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Ankle and Foot Complex.pdf

The document provides an overview of the ankle and foot complex, detailing its 28 bones, 25 joints, and the functional segments including hindfoot, midfoot, and forefoot. It describes various joints and ligaments, including the talocrural and subtalar joints, and their roles in stability and mobility. Additionally, it outlines the compartments of the leg, intrinsic muscles of the foot, and their respective nerve innervations.

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solon.kimorven
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6 views46 pages

Ankle and Foot Complex.pdf

The document provides an overview of the ankle and foot complex, detailing its 28 bones, 25 joints, and the functional segments including hindfoot, midfoot, and forefoot. It describes various joints and ligaments, including the talocrural and subtalar joints, and their roles in stability and mobility. Additionally, it outlines the compartments of the leg, intrinsic muscles of the foot, and their respective nerve innervations.

Uploaded by

solon.kimorven
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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The Ankle and Foot Complex

The Ankle and Foot Complex


• 28 bones that form 25 component joints
• Permit both stability and mobility function, depending on the
forces acting on it.
• Provides a stable base of support and function as a rigid lever
for pushing-off when walking, running, or jumping
Functional segments
• Hindfoot
• Midfoot
• Forefoot
Bones
Bones
• Distal malleoli of tibia & fibula
• Enlarged & protrude horizontally &
inferiorly
• Serve as pulley for posterior tendons to
increase mechanical advantage of
muscles in performing inversion &
eversion actions
• Increase stability in the ankle joint

Manual of
The Ankle and Foot Joints 11-5
Structural Kinesiology
Joints and Ligaments
• The Proximal and Distal Tibiofibular joints.
• Ankle/ Talocrural joint.
• Subtalar joint.
• Midtarsal joint.
• Tarsometatarsal joint.
• Metatarsophalangeal joint.
• Interphalangeal joints.
Joints and Ligaments
• The Proximal and Distal Tibiofibular joints.
• Proximal Tibiofibular joint
• Between head of fibula and lateral part of proximal tibia.
• Distal Tibiofibular
• Between the concave facet on the tibia and the convex facet of the
fibula.
• Syndesmosis
• Supported by crural tibiofibular ligament and ant. Tibiofibular
ligament.
• Forms the proximal joint surface of the ankle joint.
Joints and Ligaments
• Ankle/ Talocrural joint.
• Is the articulation between the concave surface formed by the
tibia + fibula and the convex superior surface of the talus
• 1 degree of freedom – Dorsiflexion and Plantarflexion
• 20° Dorsiflexion from neutral.
• 50° Plantarflexion from neutral.
Joints and Ligaments
• Ankle/ Talocrural joint ligaments
• Medial Collateral Ligament
• Ant. Talotibial
• Post. Talotibial
• Calcaniotibial
• Tibionavicular
• Lateral Collateral Ligament
• Ant. Talofibular
• Post. Talofibular
• Calcaneofibular
Joints and Ligaments
• Subtalar joint.
• Formed by the three plane articulations between your Talus and
Calcaneus.
• Dampens rotational forces from the proximal joints.
• Sulci from both bones form the tarsal canal
• Supported by the interosseous talocalcaneal ligament and the
ligamentum cervicis within the tarsal tunnel.
Joints and Ligaments
• Subtalar joint.
Joints and Ligaments
• Midtarsal joint.
• Talonavicular + Calcaneocuboid joint
• Aka Transverse tarsal joint, Chopart’s joint and Surgeon’s joint.
• Collectively the midtarsal joint is capable of Inversion-Eversion
and Adduction-Abduction of the foot
• Inversion-Eversion occurs at the Talonavicular jt.
• Adduction-Abduction occurs at the Calcaneocuboid jt.
Joints and Ligaments
• Ankle + Subtalar + Midtarsal joint.
• Pronation
• 0-15° up to 30°
• Supination
• 0- 45° up to 60°
Joints and Ligaments
• Midtarsal joint ligaments
• Bifurcate ligament
• Medial band Aka Lateral Calcaneonavicular ligament
• Lateral band Aka Calcaneocuboid ligament
• Dorsal Calcaneocuboid ligament
• Plantar Calcaneocuboid ligament aka short plantar ligament
• Long plantar ligament
• Has significant contribution to both transverse tarsal joint stability
and support of longitudinal arches of the foot
Joints and Ligaments
Joints and Ligaments
• Tarsometatarsal joints
• The articulation between the distal tarsal row and the bases of the
metatarsals.
• First metatarsal articulates with the medial cuneiform only.
• Second metatarsal articulates with all of the cuneiforms.
• Third metatarsal articulates with only the lateral cuneiform
• Fourth and Fifth metatarsals articulates with the cuboid.
Joints and Ligaments
• Tarsometatarsal joints
• Ray system
• A ray is a functional unit formed by a metatarsal and its associated
cuneiform
Dorsiflexion Plantarflexion
First Ray Inversion Eversion
Slight adduction Slight abduction
Second Ray Slight inversion Slight eversion
Third Ray - -
Fourth Ray Slight eversion Slight inversion
Fifth Ray Eversion Inversion
Slight abduction Slight adduction
Joints and Ligaments
• Tarsometatarsal joints
• Supination twist (weight-bearing)
• When the hindfoot pronates
• 1st and 2nd rays will be pushed into DF while the 4th and 5th rays will go
into PF to maintain contact with the ground

• Pronation twist (weight-bearing)


• When hindfoot supinates
• 4th and 5th rays will be pushed into DF while the 1st and 2nd will go into
PF to maintain contact with the ground.
Joints and Ligaments
• Metatarsophalangeal joint
• The articulation between the convex head of the metatarsal and
the concave base of the phalanges.
• 2° of freedom
• Flexion; 1st toe 0 - 45°, 2nd to 5th toes 0 - 40°
• Extension; 1st toe 0 - 70°, 2nd to 5th toes 0 - 40°
• Abduction-Adduction
Joints and Ligaments
• Metatarsal extension break
• Refers to a single oblique axis for MTP flexion/extension that lies
through the second to fifth metatarsal heads.
• It is where the foot hinges when the heel rises in weight bearing.
Joints and Ligaments
• Interphalangeal joints.
• The articulation between the convex head of the
metatarsals/phalanges and the base of the phalanges.
• 1° of freedom
• Flexion; 1st toe 0 - 90°, 2nd to 5th toes (PIP) 0 – 35° (DIP) 0 - 60°
• Extension; 1st toe 0°, 2nd to 5th toes (PIP) 0° (DIP) 0 - 30°
Arches
Arches
• Longitudinal arch – Talus
• Transverse arch – middle cuneiform
Compartments of the Leg
• The leg is divided into four compartments for the muscles.
• Anterior compartment – Deep peroneal nerve
• Lateral compartment- Superficial peroneal nerve
• Superficial Posterior compartment – Tibial nerve
• Deep Posterior compartment – Tibial nerve
Compartments of the Leg
• Anterior compartment – Deep peroneal nerve
• Tibialis Anterior - DF + Inversion.
• Extensor Digitorum Longus – DF + Extension of 2nd -5th toes.
• Peroneus Tertius – DF + Eversion.
• Extensor Hallucis Longus – DF + Extension of big toe.
Compartments of the Leg
• Lateral compartment- Superficial peroneal nerve
• Peroneus Longus – DF + Eversion
• Peroneus Brevis – DF + Eversion
Compartments of the Leg
• Superficial Posterior compartment – Tibial nerve
• Gastrocnemius – Knee flexion + Ankle PF
• Soleus – Ankle PF
• Plantaris – Knee flexion + Ankle PF
Compartments of the Leg
• Deep Posterior compartment – Tibial nerve
• Popliteus – Knee flexion + IR
• Tibialis Posterior – PF + Inversion
• Flexor Digitorum Longus – PF + Flexion 2nd – 5th toes.
• Flexor Hallucis Longus – PF + Flexion of Big toe.
Intrinsic Muscles of the Foot
• Dorsum – Deep peroneal nerve
• Plantar – Medial and Lateral plantar nerves (Branch of tibial
nerve)
• Four layers.
Intrinsic Muscles of the Foot
• Dorsum – Deep peroneal nerve
• Extensor Digitorum Brevis – MTP Extension
• Plantar – Medial and Lateral plantar nerves (Branch of tibial
nerve)
• First layer (most superficial)
• Abductor Hallucis – Abducts and Flexes MTP of Big toe.
• Flexor Digitorum Brevis – Flexes PIP of 2nd – 5th toes.
• Abductor Digiti Minimi – Abducts and Flexes small toe.
• Second Layer
• Quadratus Plantae – Adjusts oblique pull of flexor digitorum into line with long
axes of digits.
• Lumbricals – Flex MTPs, Extend IPs of 2nd – 5th digits.
Intrinsic Muscles of the Foot
• Plantar – Medial and Lateral plantar nerves (Branch of tibial nerve)
• Third Layer
• Flexor Hallucis Brevis –Flexes MTP of big toe.
• Adductor Hallucis – Adducts and Flexes MTP of big toe.
• Flexor Digiti Minimi – Flexes MTP of small toe.
• Fourth layer (Deepest layer)
• Interossei (4 dorsal; 3 plantar)
• Dorsal interossei – Abducts MTP of 2nd (either way), 3rd and 4th toes, Flexes
MTPs and Extends IPs of 2nd – 5th toes.
• Plantar interossei – Adducts MTPs of 3rd – 5th toes, Flexes MTPs and Extends
IPs of 2nd – 5th toes.
Intrinsic Muscles of the Foot
• Medial Plantar Nerve
• Abductor Hallucis
• Flexor Hallucis Brevis
• Flexor Digitorum Brevis
• First Lumbrical
• Lateral Plantar Nerve
• Abductor Digiti Minimi
• Quadratus Plantae
• 2nd-5th lumbricals
• Adductor Hallucis
• Flexor Digiti Minimi
• Interossei

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