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Ankle

Range of Motion Plantarflexion Dorsiflexion Eversion


Inversion

0 - 50 0 - 20 0 - 5
0 - 5

Open/Closed Pack Positions Open Closed 10 planterflexion Max dorsiflexion

Capsular Pattern of Loss Plantarflexion > Dorsiflexion Axis for Ankle Movement Transverse Axis Longitudinal Axis Plantarflexion and Dorsiflexion occurs at Talocrural joint Lateral to 2nd toe, for pronation and supination Inversion: Plantarflexion, Supination ( medial arch), Oblique Axis (triplanar Adduction) motions of foot) Eversion: Dorsiflexion, Pronation ( medial arch), Abduction) The foot points laterally about 300 when the knee is fully Transverse Axis of the Knee extended. (tibial external rotation)

Ligaments Lateral Collateral Ligament Complex consists of three separate bands, which function together as the static stabilizers of the lateral ankle. These are commonly involved in ankle sprains. Regardless of ankle position, the ATFL is usually the first ankle ligament to be torn in an inversion injury. Anterior talofibular Ligament (ATFL) The ATFL requires the lowest maximal load to produce failure of the lateral ligaments Resist ankle inversion in plantarflexion. Fans out at 10-40 from the tip ofthe fibular malleolus to the lateral side of the calcaneus.

Calcaneofibular Ligament (CFL)

Aids talofibular stability during dorsiflexion due its anatomic location, where it can act as a true collateral ligament and prevent talar tilt into inversion. The strongest of the lateral ligament complex. It is rarely injured except in severe ankle sprains. The ligament is coalescent with the joint capsule, and its orientation is relatively horizontal. The foot points laterally about 300 when the knee is fully extended. (tibial external rotation)

Posterior Talofibular Ligament (PTFL)

Transverse Axis of the Knee

Medial Collateral Ligament complex forms a triangular shaped ligamentous structure known as the medial (Deltoid) ligament of the ankle. Posterior Tibiotalar Ligament (superficial fibers) Tibiocalcaneal Ligament (superficial fibers) Tibionavicular Ligament (superficial fibers) Anterior Tibiotalar Ligament (deep fibers) Muscles Origin: lateral condyle of tibia Insertion: middle and distal phalanges of digits 2-5 Innervation: deep fibula (L5,51) Action: extends toes 2-5, dorsiflexion Origin: fibula Insertion: distal phalanx of big toe Innervation: deep fibular (L5,51) Action: extends big toe, dorsiflexion Origin: inferior fibula Insertion: tuberosity of 5th metatarsal Innervation: superficial fibular (L5-52) Action: evert foot, weak plantarflexion Origin: head of fibula Insertion: base of 1st metatarsal, medial cuneiform Innervation: superficial fibular (L5-52) Action: evert foot, weak plantarflexion Origin: posterior tibia Insertion: distal phalanges of toes 2-5 Innervation: tibial nerve (52,53)

Extensor digitorum longus

Extensor hallicus longus

Fibularis brevis

Fibularis longus

Flexor digitorum Longus

Action: flexes toes 2-5, plantarflexion Origin: posterior fibula Insertion: distal phalanx of big toe Innervation: tibial nerve (L4,L5,51) Action: flexes big toe Origin: lateral head - lateral condyle offemur medial head - medial condyle Insertion: calcaneus with calcaneal tendon Innervation: tibial nerve Action: plantarflexion Origin: head offibula, medial border of tibia Insertion: calcaneus with calcaneal tendon Innervation: tibial nerve Action: plantarflexion Origin: lateral condyle of tibia Insertion: base of 1st metatarsal, medial cuneiform Innervation: deep fibular (L4,L5) Action: dorsiflexion, inversion Origin: posterior surface of tibia Insertion: tuberosity of navicular, cuneiform, cuboid Innervation: tibial nerve (L4,L5) Action: plantarflexion, inversion

Flexor hallicus Longus

Gastrocnemius

Soleus

Tibialis anterior

Tibialis Posterior

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