The Ankle - The Ankle 05/29/11 05/29/11 PED 217 1 Ankle...

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Unformatted text preview: The Ankle 05/29/11 05/29/11 PED 217 1 Ankle Mortise Distal Ends of Tibia and Distal Fibula Fibula Talus Main weight bearing bone in Main foot foot Articulates with lateral and Articulates medial malleoli medial Almost square shape only Almost allows 2 movements allows • Dorsiflexion • Plantarflexion 05/29/11 05/29/11 Because tallus is wider Because anteriorly, the most stable position is in dorsiflexion position PED 217 2 Articulations Ankle Joint (talocrural Ankle joint) joint) Hinge joint ROM ROM • dorsiflexion – 20 dorsiflexion degrees degrees • plantarflexion – 50 plantarflexion degrees degrees 05/29/11 05/29/11 PED 217 3 Capsular and Ligamentous Capsular Support Support 1. 3 lateral ligaments and 1. their function their • • • Anterior talofibular lig Anterior Posterior talofibular lig Calcaneofibular lig 2. Ant. and post. tibiofibular 2. ligs ligs hold the tibia and fibula hold together together Form the distal portion of the Form interosseous membrane interosseous 05/29/11 05/29/11 PED 217 4 Medial Ligament Structure Triangular shape Attaches superiorly to the borders of the medial Attaches malleolus malleolus Attaches inferiorly to the medial surface of the Attaches talus, to the sustentaculum tali of the calcaneous and to the posterior margin of the navicular and Primary resistance to foot is [eversion] Along with calcaneonavicular lig helps to Along maintain the inner longitudinal arch maintain 05/29/11 05/29/11 PED 217 5 Ankle Injury Prevention How can we help to prevent ankle How injuries? injuries? 05/29/11 05/29/11 Stretching the Achilles tendon Strengthening the musculature Proprioceptive training Wearing proper footwear Proper taping PED 217 6 Ankle Assessment History Observation Palpation Range of Motion Strength Special Tests 05/29/11 05/29/11 PED 217 7 Ankle – Special Tests Anterior Drawer Anterior Talar Tilt Talar ( test the Calcanofibular ligament test (which is usally and inversion sprain.) sprain.) Percussion Test (test the Anterior talofib) Tests for fractures Look for pain on the side of the Look fracture fracture Squeeze Test Also injury to the sydesmosis Also sprain (inneroseous tendon between bones) between Fracture test Thompson’s Test 05/29/11 05/29/11 PED 217 8 The Sprained Ankle Generally caused by sudden lateral or Generally medial twists medial Inversion sprain – most common – 90% Inversion due to more bony stability on the lateral side because the length of the tibia is longer and bigger. longer 05/29/11 05/29/11 PED 217 9 Grade I inversion ankle sprain Most common type – Most usually involves the anterior talofibular lig anterior (Grade 1 –mild) – (Grade signs and symptoms signs Mechanism? Signs and Symptoms? Treatment? 05/29/11 05/29/11 PED 217 Minimal to no swelling Mild/pt tender No discoloration/ No eccymosis eccymosis Normal full ROM and Normal strength(full weight bearing) Specials test – Specials negative negative TREATMENT 10 Grade II inversion ankle sprain Causes great deal of disability Signs and symptoms Causes Mild to moderate swelling with many days of lost time Moderat/diffuse pain Moderat/diffuse (3days - a week) (3days Usually involves the anterior Usually talofib and calcaneofibular ligaments ligaments Mechanism? Signs and Symptoms? Treatment? 05/29/11 05/29/11 TREATMENT PED 217 Eccymosis = yes Decrease ROM and strength Decrease (limited weight bearing) Special Test • A Positive = Anterior Positive Drawer, Talar tilt Drawer, RICE again May need 2 stay off at May first first Then start some Then 11 Grade III inversion ankle sprains Relatively uncommon in Relatively sports sports Usually involves the Usually anterior talofibular ligament, posterior talofibular ligament, and calcaneofibular ligament calcaneofibular Mechanism? Signs and Symptoms? Treatment? 05/29/11 PED 217 05/29/11 Signs and symptoms •Medium to sever swelling •Diffuse/no pain •Eccymosis = yes •Decreased to no ROM and trength •Positive tests = TREATMENT 12 Eversion Ankle Sprain 5-10% of all ankle sprains More serious than lateral ankle sprains Because of the increase risk of fracture due to Because the lateral maleolus being Mechanism? Signs and symptoms? Treatment? 05/29/11 05/29/11 PED 217 13 Syndesmosis Ankle Sprain Relatively common Relatively injury in football because because Forceful external Forceful rotation( cleat planted and hit in another direction) direction) Mechanism? Signs and symptoms? Klieger’s test, speeze Klieger’s or compression test 05/29/11 also PED 217 05/29/11 also 14 Acute Injuries to the Ankle and Acute Related Structures Related Achilles Tendon Strain Mild/moderate soreness Thompson’s will probably be neg here Achilles Tendon Rupture The lumpiness indicates a rupture The (depression) (depression) Some treated by surgery Some treated by putting foot in a boot and lay Some off walking off 05/29/11 Affects older pop. More (30 +) PED 217 15 05/29/11 Affects 05/29/11 05/29/11 PED 217 16 Chronic Ankle Tendon Chronic Conditions Conditions Achilles Tendinitis – surrounding the Achilles tendon is a paratendon consisting of fatty and areolar tissue that surrounds the tendon and fills the space around it the Peroneal Tendon Peroneal Subluxation/Dislocation Subluxation/Dislocation 05/29/11 05/29/11 PED 217 17 ...
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This note was uploaded on 05/29/2011 for the course PED 217 taught by Professor Bartz during the Spring '08 term at Grand Valley State University.

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