Ankle Anatomy Quiz: Master the Ankle Joint

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Questions and Answers

What is the approximate percentage of individuals who do well after a compression fracture without wound complications?

50%

100%

75% (correct)

90%

What is the primary goal when managing paediatric ankle fractures?

Apply a below knee cast

Reduce and hold or fix

Use K-wires or cannulated screws

Avoid injury to physis (correct)

What is the typical mechanism of injury for a talar neck fracture?

Forced plantarflexion with axial loading

Forced inversion with axial loading

Sudden dorsiflexion

Forced dorsiflexion with axial loading (correct)

What is the common location of an Achilles tendon rupture?

4-6 cm above the insertion of the Achilles tendon Signup and view all the answers

What is the age range when Achilles tendon ruptures are most common?

30-40 years Signup and view all the answers

What is the anatomical composition of the Achilles tendon?

Soleus muscle and medial and lateral gastrocnemius tendons Signup and view all the answers

What is the primary restraint to talar shift?

Deltoid ligament Signup and view all the answers

What percentage of ankle fractures are isolated malleolus fractures?

70% Signup and view all the answers

What is the indication for operative treatment in ankle sprains?

Persistent pain and instability Signup and view all the answers

What is the purpose of stress views in the investigation of ankle sprains?

To evaluate instability Signup and view all the answers

What is the outcome of ankle fractures in terms of recovery?

Full recovery may take a long time Signup and view all the answers

What type of injury is a pilon fracture?

Combination of ankle fracture and distal tibia fracture Signup and view all the answers

What is the main motion of the ankle joint?

Dorsiflexion and Plantar flexion Signup and view all the answers

Which ligament is responsible for the integrity of the ankle mortise?

Syndesmosis Signup and view all the answers

What is the most common type of ankle sprain?

Low ankle sprain Signup and view all the answers

What is the motion of the fibula within the incisura fibularis during gait?

Rotation within incisura Signup and view all the answers

What is the percentage of ankle sprains that are high ankle sprains?

Less than 10% Signup and view all the answers

What is the mechanism of injury for a low ankle sprain?

Inversion injury in plantarflexed ankle Signup and view all the answers

Study Notes

Compression Fracture

Takes approximately 4 months to heal
Around 75% of patients do well without wound complications
10% risk of requiring ankle arthrodesis

Paediatric Ankle Fracture

Salter Harris fractures are common
Avoid injury to physis
May use K-wires or cannulated screws to reduce physis injury
Triplaner fracture requires CT scan
Talus fracture is rare

Talus Fracture

Talar neck fractures are high-energy injuries
High incidence of talus avascular necrosis
CT scan is usually required
May associate with talus dislocation
Treatment involves reduction and fixation

Talar Body Fracture

Rare
May be lateral process, posterior process, or talar head fracture
Diagnosis involves X-ray and CT scan
Treatment is usually non-operative unless the fracture is displaced or intra-articular

Achilles Tendon Rupture

Common tendon injury
Mechanism: Sudden dorsiflexion, often in sports
Typically occurs in males aged 30-40
Rupture usually occurs 4-6 cm above the insertion
History: Patient feels a "pop" and experiences weakness and pain with weight-bearing
Signs: Swelling, ecchymosis, tenderness, and positive anterior drawer test and talar tilt test
Investigation: X-ray, stress views, and MRI
Treatment: Non-operative or operative, depending on pain and instability

Ankle Fractures

Very common
Usually due to twisting injury
Affect all ages
Types: Isolated malleolus (70%), bimalleolar (20%), and trimalleolar (7%)
Weber (Danis-Weber) classification:
- Type A: Below syndesmosis
- Type B: Trans syndesmosis
- Type C: Above syndesmosis
Biomechanics: Deltoid ligament is primary restraint to talar shift, and fibula acts as buttress to prevent lateral talar shift
Presentation: Symptoms and signs of pain, swelling, and deformity
Investigation: X-ray, CT scan, and MRI
Treatment: Non-operative or operative, depending on the severity of the fracture
Outcome: Over 90% success rate, but full recovery may take a long time

Pilon Fracture

Combination of ankle fracture and distal tibia fracture
High-energy injury
Significant associated soft tissue injury
Around 25% are open fractures
Mechanism: Vertical compression

Ankle Joint

Bones: Tibial plafond, medial malleolus, lateral malleolus, and talus
Motion: Plantar flexion, dorsiflexion, inversion, eversion, and rotation
Ligaments: Medial, deltoid, lateral, anterior talofibular, posterior talofibular, calcaneal fibular, and lateral talocalcaneal

Distal Tibiofibular Joint

Bones: Distal fibula and incisura fibularis
Motion: Rotation during gait
Ligaments: Syndesmosis, anterior inferior tibiofibular, posterior inferior tibiofibular, transverse tibiofibular, and interosseous

Ankle Sprain

Very common
Twisting injury
Diagnosis: Clinical
Treatment: Usually conservative
Mechanism: Inversion injury in plantarflexed ankle
High ankle sprain (syndesmosis injury) is less than 10% of ankle sprains
Low ankle sprain (ATFL and CFL) is more than 90% of all ankle sprains
Associated injuries: Osteochondral fractures, peroneal tendon injuries, and deltoid ligament injury

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Description

This quiz covers the bones, ligaments, and motions of the ankle joint, including the tibial plafond, medial and lateral malleoli, and talus. Test your knowledge of the anatomy of the ankle joint and its various components.

Anatomy of the Ankle Joint

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