Injuries to the Lower Leg and Ankle

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Injuries to the Lower Leg and Ankle
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Lower Leg Injuries

• Caution! Graphic Picture

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Contusions

• Shin contusion
• - little soft tissue to absorb force
• - Periosteum receives impact
• - MOI Direct blow

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Compartment Syndrome

• Increased pressure in compartments compromises
  muscles, nerves, or blood vessels
• 4 compartments in lower leg
• Caused by overuse or direct contact
• Athlete has pain, decreased sensation over foot,
  possible foot drop

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Fasciotomy
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Muscle Strain

• Calf is most affected (usually at
  gastroc-achilles junction)
• MOI violent contraction
• excessive dorsiflexion
• overuse

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Achilles Tendonitis

• Inflammation of the Achilles
• MOI overuse, microtearing of tendon
• Signs pain, point tender, crepitus, swelling

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Achilles Tendon Tear

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Muscle Spasm

• Calf usually affected
• MOI fatigue, dehydration
• Treatment direct compression, gradual stretch,
  ice, rehydrate

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Leg Fractures

• Direct blows or indirect trauma
• Fibular fracture more common
• Deformity, pain, unable to bear weight (Fibula?)

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Stress Fractures

• An incomplete break in a bone occurring after
  prolonged repetitive exercise

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Stress Fractures (cont)

• Signs and Symptoms
• - intense pain
• - point tender
• - more painful after activity
• - percussion test

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Medial Tibial Stress Syndrome

• shinsplints
• Pain along medial border of the tibia
• Usually with novice runners well conditioned
  runners usually due to mechanical abnormalities

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• Causes - running on hard
• surfaces
• - Overuse
• - Muscle imbalance
• - Tight Achilles

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Ankle Injuries
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Mechanisms of Injuries

• Inversion
• - bony stability is greater medially than
  laterally
• - fibula extends more distally than tibia
  prevents eversion
• - occur from running on uneven surfaces or
  cutting

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• Plantar Flexion
• - Usually sprain ankle when in plantar flexion.
• - Ankle is unstable in this position

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• Eversion
• - usually due to a planted foot that receives a
  lateral force
• - stepping in a hole
• - higher incidence of fractures

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Lateral Ligament Sprain

• Most common ankle injury
• MOI Inversion and plantar flexion

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• Anterior Talofibular Ligament (ATF) is injured
  first. (mild sprain)
• The Calcaneofibular Ligament (CF) is injured in
  more severe sprains
• The Posterior Talofibular Ligament is injured in
  the most severe sprains

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INVERSION ANKLE SPRAIN

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Ankle inversion

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Medial Ligament Sprain(Deltoid Ligament)

• Often associated
• with fractures
• of
• lateral malleolus

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• Often associated
• with a blow to
• lateral side of body

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• Eversion Sprain

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The Deltoid Ligament

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Peroneal Tendon Injury

• Attach Peroneus longus muscle of the Lateral
  compartment to foot
• Eversion of foot and ankle

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• Can occur when lateral ankle ligaments are
  injured
• Common problems are dislocation of tendons over
  lateral malleolus
• or peroneal tendonitis

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Surgical Repair of Peroneal Tendons
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