Foot Bones & Skeletal Trauma
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Transcript Foot Bones & Skeletal Trauma
Ankle Injuries
Ankle Sprains
Single most common injury in athletics caused
by sudden inversion or eversion moments
Tibia
Fibula
Lateral Malleolus
Medial Malleolus
Bones
of
Foot & Ankle
Medial Aspect
Medial Malleolus
Head of Talus
Foot & Ankle Bones
Tarsal
sinus
Calcaneous
Cuboid
Lateral View
3rd - 5th
Metatarsals
Talus
Lateral Ligaments
Anterior Tibiofibular Ligament
Palpation
External Rotation Test
Locate area where tibia and
fibula meet
Spring Test
Anterior Talofibular Ligament
Palpation
Superior to sinus tarsi
Anterior Drawer Test
Anterior translation of talus under tibia
May cause a clunking at end point
Indicates laxity
Posterior Talofibular Ligament
Posterior Drawer Test
Stabilize Tibia
Apply a posterior stress to the foot and ankle
Posterior translation indicates ligament laxity
Talar Tilt Test (Varus Stress)
Assessment
Calcaneofibular ligament
Apply a varus stress to calcaneous
Grade 1-3+
Feel for cluck
Deltoid Ligaments
Valgus Stress Test
Inversion Sprains
Injury to the lateral ligaments
Anterior talofibular ligament
Inversion
Plantar flexion
Internal rotation
Calcaneofibular ligament
Inversion
Inversion Sprain
Symptoms
Pain
Active motion
Resistive motion
Loss of function
Signs
Tenderness
Swelling
Ecchymosis
1º Inversion Sprain
Symptoms
Pain: mild
Active motion
Resistive motion
Loss of function
Weight bearing minimally impaired
Signs
Point Tenderness
Swelling
Ecchymosis
No laxity
Management
RICE
Weight bearing to tolerance
Tape or brace
Modalities as needed
Strengthening
Return to activity when functional
Average return 7-10 days
2º Inversion Sprain
Etiology
Moderate inversion force
Pathology
Partial tearing of ligaments
Anterior Talofibular
Calcaneofibular
Signs and Symptoms
Pop or snap heard or felt
Moderate pain
Moderate disability
Management
RICE up to 72 hours
X-ray if unable to weight bear
Crutches 5-10 days
Progress to weight bearing
Protective immobilization
Tape or brace
Modalities as needed
Early ROM exercises
Strength & proprioception
exercises
Return to activity when
functional
Average return 7-10 days
Difficulty bearing weight
Tenderness
Edema
3º Inversion Sprain
Etiology
Signs and Symptoms
Relatively uncommon
Significant inversion force
Subluxation and relocation
Pathology
Anterior talofibular ligament
Calcaneofibular ligament
Anterior tibiofibular ligament
Severe pain
Edema
Hemarthrosis (blood in joint)
Ecchymosis
Inability to bear weight
Positive Tests
Anterior drawer
Talar Tilt
Management
RICE
Refer to MD
Eversion Sprain
Etiology
Indirect
Direct force
Eversion of ankle
Inversion of ankle
Signs
Crush injury
Symptoms
Pain
Tenderness
Active motion
Resistive motion
Loss of function
Weight bearing
Collapse of arch
Special Tests
Deltoid ligaments
Swelling
Ecchymosis
Valgus stress
External rotation test
Management
Arch and ankle taping
Orthotics
Ankle
Dislocation
Assess neurovascular status