Ankle Injury Management Module J2

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

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

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

Ligaments

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

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

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

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

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

Tap test Tinel’s sign Malleolus fx

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

The End Questions???