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THE ANKLE Chapter 15.

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Presentation on theme: "THE ANKLE Chapter 15."— Presentation transcript:

1 THE ANKLE Chapter 15

2 ANKLE ANATOMY BONES Two bones in the lower leg Two tarsal bone
Tibia – medial, larger, weight bearing Medial Malleolus Fibula Lateral Malleolus Two tarsal bone Talus Calcaneus

3 ANKLE ANATOMY TRUE ANKLE JOINT Tibia, fibula and talus Mortise
Definition: where the talus fits into the tibia and the fibula

4 ANKLE JOINTS Subtalar joint Between the Talus and the Calcaneus

5 LIGAMENTS – p. 317 LATERAL SIDE– 3 ligaments named for bones
Anterior talofibular (ATF) Calcaneofibular (CF) Posterior talofibular (PTF)


7 LIGAMENTS – p. 317 MEDIAL SIDE Deltoid Strong ligament
4 parts that form one ligament


9 LIGAMENTS TIBIOFIBULAR LIGAMENTS – holds tibia and fibula together
Anterior tibiofibular Posterior tibiofibular

10 MUSCLES The muscles that move the ankle are found in the lower leg – not around the ankle joint (we will talk more about this in the lower leg injury section)

11 ANKLE MOTIONS Dorsiflexion Plantarflexion Inversion Eversion

12 Injuries

13 TYPES OF ANKLE SPRAINS Inversion Most common type of ankle sprain
Accounts for 80% of all sprains AKA ‘a lateral ankle sprain’ First degree sprain Only involves the anterior talofibular ligament Mild pain, tenderness, and swelling No instability

14 TYPES OF ANKLE SPRAINS Inversion Second degree sprain
Anterior talofibular ligament is torn and calcaneofibular ligament is injured as well Most painful Moderate swelling Mild Instability

Inversion Third degree sprain Complete tear of all three lateral ligaments Uncommon Lots of pain, but it can subside Very unstable Usually requires surgery

16 TESTING ATF STABILITY Drawer Test Stablize lower leg with one hand
Pull heel forward (like opening a drawer) Should not move forward if ligament is intact

17 TYPES OF ANKLE SPRAINS Eversion Not as common
Can occur more on tartan surfaces and artificial turf Everything is worse (pain, swelling, etc) when compared to an inversion injury If the deltoid tears, the tibiofibular ligaments may tear also

18 High Ankle Sprain Involves Anterior Inferior Tibiofibular (AITFL) Ligament Injury allows tibia and fibula to separate

19 High Ankle Sprain Cause: Inversion with rotation; rotation of foot
S/S: pain with external rotation of foot; tender over AITFL Treatment: RICE, may need to be immobilized; possible surgery if severe enough

20 Treatment of Ankle Sprains
Prevention – once you sprain an ankle it is easy to do again – tape and rehab Rest – No activity for hours Ice – 20 minutes on, 40 minutes off Compression – ace wrap with horseshoe Elevation – ankle above the heart Support – crutches and aircast if needed

21 Ankle Rehab ABCs Circles Theraband exercises Single Leg Balance
Balance Board Calf Raises And so much more….

22 Distal Tibia/Fibula Fractures
Always need to suspect a fracture when evaluating a potential sprained ankle Cause: Too much motion S/S: immediate swelling, point tender over the bone, does not want to weight bear Treatment: splint, ice, x-ray Cast 6-8 weeks

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