Ankle Joint Case Study

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• Anatomy Of The Ankle Joint Anatomy of Ankle Joint The ankle joint is synovial in type and involves the talus of the foot and tibia and fibula of the leg. The ankle joint mainly allows hinge-like dorsiflexion and plantarflexion of the foot on the leg. The distal end of the fibula is firmly anchored to the larger distal end of the tibia by strong ligaments. Together, the fibula and tibia create a deep bracket-shaped socket for the upper expanded part of the body of the talus. (Fig 1_1): • The roof of the socket is formed by the inferior surface of the distal end of the tibia. • The medial side of the socket is formed by the medial malleolus of the tibia. • The longerlateral side of the socket is formedby the lateral malleolus of the…show more content…
1. Calcaneal Tendon ( Achilles tendon ) The calcaneal tendon is the largesttendon entering the foot and is prominent on theposterior aspect of the foot as it descendsfrom the leg to the heel. (Gray’s, 2015). Achilles tendon: formed by gastrocnemius andsoleus to attach distally to the posterior superiorcalcaneum. (Gray’s, 2015). During its course, the tendon fibres rotate laterally and inserts into the posterior calcanealtuberosity. The tendon is not surrounded bya synovial sheath (Bianchi et al., 2005). (2) Lateral Group of Tendons There are two tendons that can be found lateral to the ankle: The anterior peroneusbrevis tendons and the posteriorperoneus longus. These tendons course posterior and inferior to the lateral malleolus, and share commonsheath proximally, but have separate sheaths in the inframalleolar region. The peroneusbrevis is smaller than the peroneuslongus and lies anterior to it, coursing in a shallow retromalleolar groove on the posterior border of the lateralmalleolus. There is a close relationship of the common peronealtendon sheath, and the adjacent posterior talofibular and the calcaneofibular ligament (Martinoli and Bianchi,…show more content…
Distally to the medialmalleolus, it runs against the internal face of the sustentaculumtali. It then reaches the plantar of the foot and, after passing inferior to the FHL, attaches into the distal phalanx of the fourlateral toes (Bianchi et al., 2005). The FHL muscle lies in a median position, with respect to the axis of the ankle, anterior to the Achillestendon. It continues distally with a strong tendon that reflects over the posterior aspect of thetalus passing between the lateral and medial posteriortubercles. Then the tendon reflects under the sustentaculumtali of the calcaneus; in the sole of the foot it runsforward between the two heads of the Flexor hallucisbrevis, and is inserted into the base of the last phalanx of the great toe. (Martinoli et al., 2000) (Cheung et al, 2005). All these tendons run in the so-called tarsaltunnel, made by the posteromedial aspect of the distaltibia and the medial faces of the talus and calcaneum and by the medialretinaculum. In addition to the medial tendons, the tunnel houses the posteromedial vasculo-nervous bundle made by the posteriortibial artery, its two satelliteveins, and the posterior tibial nerve. Inside thetunnel, the nerve splits into three terminal distalbranches: the medial and lateral plantar nerves and the calcanealnerve (Martinoli et al.,

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