1. Ankle Injury Management
Module J2

2. Bones and Prominent Boney Features
Calcaneus
Talus
Cuboid
Navicular
Cuneiforms
Tibia
Fibula

3. 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

4. Ligaments Anterior/posterior tibiofibular- (aka syndesmotic ligaments)
Calcaneofibular-
Anterior talofibular
Deltoid
Peroneal retinaculum

5. Ligaments

6. Muscles Ant. Tibialis Flexor hallicus longus Flexor digitorum longus
Posterior tibialis
Extensor hallicus longus
Extensor digitorum longus
Peroneus longus
Peroneus brevis
Peroneus tertius
Gastrocnemius
Soleus

7. Other structures Anterior tibial artery Deep peroneal n.
Superficial peroneal n
Posterior tibial n.

9. 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

10. 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

11. 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

12. Tap test
Tinel’s sign
Malleolus fx

13. Injuries and Conditions
1st° ankle
2nd° ankle
3rd° ankle
Sprain- dislocation
Anterior tibial strain
Peroneal strain
Fracture
Stress fracture
Avulsion fracture

14. The End
Questions???