Ankle Injury Management

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Ankle Injury Management

• Module J2

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Bones and Prominent Boney Features

• Calcaneus
• Talus
• Cuboid
• Navicular
• Cuneiforms
• Tibia
• Fibula

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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

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Ligaments

• Anterior/posterior tibiofibular- (aka syndesmotic
  ligaments)
• Calcaneofibular-
• Anterior talofibular
• Deltoid
• Peroneal retinaculum

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Ligaments
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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

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Other structures

• Anterior tibial artery
• Deep peroneal n.
• Superficial peroneal n
• Posterior tibial n.

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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

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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

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Kleigers 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

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Tap test

• Tinels sign
• Malleolus fx

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Injuries and Conditions

• 1st ankle
• 2nd ankle
• 3rd ankle
• Sprain- dislocation
• Anterior tibial strain

• Peroneal strain
• Fracture
• Stress fracture
• Avulsion fracture

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The End

• Questions???