Chapter 16- Foot, Ankle, and Lower Leg Conditions

Heel Contusion

A contusion to the hindfoot , called a heel bruise.

Tibial Contusion

A contusion to the tibia, commonly called a shin bruise.

Ankle Sprains

Ankle sprains are the most common injury in recreational and competitive sports. In basketball , ankle sprains comprise more than 45% of all injuries.

Toe Deformities

Hallus Rigidus- Degenerative arthritis in the first MTP joint, associated with pain and limited motion, is known as hallus rigidus. Hallus Valgus - Prolonged pressure against the medial aspect of the first MTP joint can lead to thickening of the medial capsule and bursa.

Introduction

Lateral ankle sprains are the most common of all sports related injuries

Toe and Foot Conditions

Malalignment syndrome ( e.g., pes cavus , pes Planus and hammer or claw toes)

Dorsiflexion and Plantar Flexion

Motion at the ankle occurs primarily in the sagittal plane, with ankle ankle flexion and extension being termed dorsiflexion and plantar flexion.

Pes Cavus

Pes Cavus is an excessively high arch that does not flatten during weight - bearing . Pes planus is the opposite of pes plavus . The condition, referred to as flat foot.

Prevention of Foot, Ankle and Lower Leg Conditions

Protective Equipment Shin pads can protect the anterior tibia area from direct impact by a ball, bat, stick or a kick from a foot.

Inversion and Eversion

Rotations of the foot in the medial and lateral directions are termed inversion and eversion.

Toe Flexion and Extension

Several muscles contribute to the flexion of the second through fifth toes. These include the flexor digitorum longus, flexor digitorum brevis, quadratus plantae, lumbricals and interossei.

Nerves and Blood Vessels of the Lower Leg, Ankle , and Foot

The blood supply to the lower leg, ankle , and foot enters the lower extremity as the femoral artery.

Plantar Arches

The bones and supporting ligamentous structures in the tarsal and matatarsal regions of the foot from interdependent longitudinal and transverse arches. They function to support and distribute body weight from the talus through the foot. The plantar fascia, is a specialized, thick, interconnected band of fascia that covers the plantar surface of the foot, providing support for the longitudial arch.

Anatomy Review of the Foot, Ankle, and Lower Leg

The foot, in particular , has three major regions, namely the forefoot, midfoot and hindfoot.

Forefoot

The forefoot is composed of five metatarsals and 14 phalanges, along with numerous joints. MTP The first digit is referred to as the hallux. The first MTP join has two sesamoid bones.

The Gait Cycle

The gait cycle requires a set of coordinated, sequential joint actions of the lower exteremity.

Hindfoot

The hindfoot includes the calcaneus and talus. The talus is saddle- shaped.

Midfoot

The midfoot region consists of navicular,cuboid and three cuneiform bones. The CC joint is a saddle -shaped joint with a close- packed position in supination. The remaining joint of the midfoot region include the cuneonavicular, cuboideonavicular, cuneocuboid, and intercuneiform. These joints provide gliding and rotation for the midfoot with a close- packed position in supination.

Foot and Ankle Sprain

Toe and Foot Sprains and Dislocations The toes and feet can be common sites for sprains particularly during an activity in which there is minimal support for the foot.