ankle and leg injuries
DESCRIPTION
Ankle and Leg Injuries. ROP SPORTS MEDICINE Stacy Camou. Skeletal Anatomy. Talus Tibia Medial aspect Larger of the two leg bones Second longest bone in body Primary weight bearing bone in leg Fibula Lateral aspect Functions to provide muscle attachments Non-weight bearing. - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/1.jpg)
Ankle and Leg Injuries
ROP SPORTS MEDICINEStacy Camou
![Page 2: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/2.jpg)
Skeletal Anatomy• Talus• Tibia
– Medial aspect– Larger of the two leg bones– Second longest bone in body– Primary weight bearing bone in leg
• Fibula– Lateral aspect– Functions to provide muscle attachments– Non-weight bearing
![Page 3: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/3.jpg)
Skeletal Anatomy
![Page 4: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/4.jpg)
Articulations• Talocrural joint = Ankle joint
– Made up of the tibia, fibula, and talus– Talus is wedge shaped– Lateral malleolus extends more distally than the
medial malleolus • Proximal to Distal tibiofibular joint is connected
by– Syndesmosis Joint (HIGH ANKLE SPRAIN)
![Page 5: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/5.jpg)
Articulations- Talocrural Joint
![Page 6: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/6.jpg)
Articulations
![Page 7: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/7.jpg)
Musculoskeletal Anatomy• 4 Compartments of the leg
– Anterior compartment (most commonly Injured)• Tibialis anterior• Extensor hallicus longus• Extensor digitorum longus• Peroneus tertius• Anterior tibial artery and vein• Deep peroneal nerve
– Lateral compartment• Peroneus longus• Peroneus brevis• Superficial peroneal nerve
![Page 8: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/8.jpg)
Musculoskeletal Anatomy• Compartments of the leg
– Deep posterior compartment• Tibialis posterior• Flexor hallucis longus• Flexor digitorum longus• Posterior tibial artery and vein• Tibial nerve• Superficial posterior• Gastrocnemius• Soleus• Plantaris
![Page 9: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/9.jpg)
Musculoskeletal Anatomy
![Page 10: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/10.jpg)
Ligamentous Anatomy
• Ankle– Medial aspect
• Deltoid ligament• Thick and strong
– Lateral aspect• Anterior talofibular • Posterior talofibular • Calcaneofibular
• Leg– Proximal and distal anterior and posterior
tibiofibular ligaments
+ Interosseous membrane=Syndesmosis Ligaments
![Page 11: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/11.jpg)
Ligamentous Anatomy
![Page 13: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/13.jpg)
Gastrocnemius
Soleus
Achilles Tendon
Tibialis Anterior
Peroneus Longus Peroneus Brevis
![Page 14: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/14.jpg)
Fractures• Avulsions
– Piece of tibia/fibula is pulled off by ligament– Fairly common– X-rays for all ankle sprains
![Page 15: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/15.jpg)
Fractures
![Page 16: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/16.jpg)
Fractures• Tibia
– Traumatic fractures are serious due to size of bone– Stress fractures
• Medial tibial stress syndrome• “shin splints”
• Fibula– Fairly common– Non-weight bearing; competition possible– Stress fractures
• Reasonably common due to muscle attachments• Both bones
– Usually requires surgery to stabilize
![Page 17: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/17.jpg)
Fractures
![Page 18: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/18.jpg)
Strains• Gastrocnemius/Soleus strain occurs:
– Muscle belly– Musculotendinous junction
• Anterior extensors strain– Often called “shin splints” (lateral to tibial ridge)– M.O.I = Hill, climbing, or speed work– May lead to chronic compartment syndrome
• Toe flexors– Often called “shin splints” (medial to tibial ridge)– M.O.I = Pronation increases odds
• Achilles tendon– Strain vs tendonitis ( can lead to rupture )
![Page 19: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/19.jpg)
Strains• Achilles tendon rupture
– Most common over 30 years old– Chronic history of inflammationor– Acute Sudden push off– Signs and symptoms
• “I was kicked in the back of the leg!!”• Immediate pain• Palpable defect• Positive Thompson’s test
![Page 20: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/20.jpg)
STRAINS
![Page 21: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/21.jpg)
Thompson’s Test
![Page 22: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/22.jpg)
Sprains• Lateral ankle sprains
– M.O.I = Inversion/plantar flexion mechanism– Most common injury in body– 90-95% of all ankle sprains occur to lateral
ligaments…..Why?• Strong medial ligaments• Fibular block
– Ligaments involved• Anterior talofibular or ATFL• Calcaneofibular or CFL• Posterior talofibular or PTFL
– Mild to severe grades (1°-3°)
![Page 23: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/23.jpg)
Lateral Ankle Sprain
![Page 24: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/24.jpg)
Sprains• Medial ankle sprains
– M.O.I = Eversion mechanism– Rare (5%) occur medially….WHY????
• Strong deltoid ligament• Fibular block
– Deltoid ligaments Injured– Graded Mild to severe (1°-3°)
• Syndesmosis sprain– M.O.I = Forced dorsiflexion and/or eversion– “High ankle sprain”– Slow to heal– Anterior tibiofibular (ATFL) ligament and interosseous
membrane are the ligaments injured
![Page 25: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/25.jpg)
Medial Ankle Sprain
![Page 26: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/26.jpg)
Other Conditions
• Achilles tendonitis/tenosynovitis– Inflammation of the tendon or sheath
surrounding the tendon– Causes hypertrophic scarring
Achilles Tendon Rupture
![Page 27: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/27.jpg)
Achilles Tendonitis
![Page 28: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/28.jpg)
ACHILlES TENDON RUPTURE
![Page 29: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/29.jpg)
Other Conditions• Compartment syndrome
– Typically anterior or deep posterior compartments– Acute
• Caused by direct blow or injury within fascial compartment• Medical emergency• Taut, shiny appearance of skin• Foot drop if advanced• Requires surgical decompression
– Chronic• Muscle hypertrophy during exercise
– Decreased space in compartment• Slow, continual rise in temperature
– Treatment???
![Page 30: Ankle and Leg Injuries](https://reader035.vdocuments.us/reader035/viewer/2022062316/568166db550346895ddafc88/html5/thumbnails/30.jpg)
If pressure is too high surgery will be required.