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???