Ankle Joint Complex PDF

Ankle joint complex 1. Anatomic considerations - DISTAL TIBIO-FIBULAR JOINT: - Fibrous joints → syndesmosis - Triangular zone of the inferior part of the fibula + inferior external factet of the tibia - TIBIO-FIBULAR-TALAR JOINT:...

Ankle joint complex 1. Anatomic considerations - DISTAL TIBIO-FIBULAR JOINT: - Fibrous joints → syndesmosis - Triangular zone of the inferior part of the fibula + inferior external factet of the tibia - TIBIO-FIBULAR-TALAR JOINT: - Troquelar joint - Single degree of freedom - Tibiofibular mortise (concave) + talar pulley (convex) - SUBTALAR JOINT: - Troquelar joint - Single degree of freedom (Henke axis) - The upperside of the talus (concave) + the upper face of the calcaneus (convex) 2. Range of motion - DORSIFLEXION: 20º-30º - PLANTAR FLEXION: 30º - 50º - INVERSION: - Plantarflexion - Approximation - Supination - EVERSION: - Dorsiflexion - Separation - Pronation 3. Main ankle muscles - ANTERIOR TIBIAL: dorsiflexion and inversion - LARGE EXTENSOR OF THE THUMB: dorsiflexion - COMMON EXTENSOR: dorsiflexion and eversion - SHORT LATERAL PERONEUS: plantarflexion and eversion - LONG LATERAL PERONEUS: plantarflexion and eversion  4. Tests: SOLEUS LENGTH TEST: - Performance: patient standing with the heel supported and foot separated from the wall. We ask him to touch the knee with the wall. We should repeat the test until the patient finds the position which leaves the heel off the ground. - Outcome: distance from the first finder to the wall minor than eleven centimeters - Significance: possible soleus shortness → decreased ankle mobility HEEL RISE TEST: - Performance: patient standing and we ask him to stand on tiptoe - Outcome: test is positive if calcaneus doesn’t change from valgus to varus - Significance: weakness of the posterior tibial LANDING TEST: - Performance: patient standing on a step and we ask him to perform a unipodal landing - Outcome: instability - Significance: weakness of the peroneal muscles STAR EXCURSION BALANCE TEST: - Performance: patient standing on unipodal support and we ask him to touch the eight tips of the star with the opposite foot - Outcome: reach distance and instability - Significance: muscle imbalance, lack of flexibility and lack of proprioception