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Arches are designed to carry our body weight

Formed by tarsals and meta tarsals

Strengthened by ligaments, muscles,

tendons, aponeurosis

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Medial and lateral

Anterior and posterior4

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Features

Bones forming the

arch

Main joint of the

arch

Summit of the

arch

Pillars of the arch

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Calcaneum

Bones of the arch

Main Joint: Talocalcaneonavicular

joint

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Pillars: Anterior: heads of medial 3 metatarsals Posterior: Medial tubercle of calcaneus

Lies at trochlear surface of talus

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Main joint: Calcaneo cuboidBones: Calcaneus, Cuboid and heads of 4th & 5th metatarsalsSummit: lies at Subtalar jointPillars:

Anterior: Heads of 4th & 5th metatarsals

Posterior: lateral tubercle of calcaneus

Approximation of both feet

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Anterior arch: By heads of all 5 metatarsals

Posterior arch: by greater part of tarsals, Metatarsals

Complete

• Incomplete – only lateral end comes in contact with ground

• Completes with opposite foot

Maintaining factors

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Shape of the bones: Faceted at different angles

Inter-segmental ties: structures connecting adjacent

bones

Tie- beams: Structures connecting 2 ends of

arch

Sling: Structure suspend arch from

above - - keep the summit pulled up

Shape of the bonesIntersegmental ties

Tie beams

Slings

Slings

Shape of the bonesTie beams / bow stringsIntersegmental ties

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Maintenance of medial longitudinal arch Shape of the bones- faceted at

different angles

Thinner edge

Sup.

Inf.

13Spring ligament

Intersegmental tiers...

Tie-beams…

Abductor hallucis (1)

Plantar aponeurosis

Flexor digitorum brevis (1)

Flexor hallucis brevis (3)

Flexor hallucis longus (2)14

Slings Slings ……

Tibialis anterior

Tibialis posterior

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Shape of bones

Short plantar ligamentLong plantar ligament

Intersegmental tiers

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Tie beams…

Aponeurosis AbDM

FDB

FDL

FDMB

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SlingsSlings……

Peroneus longus Peroneus brevis18

Peroneus tertius

Shape of bones

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Wedge shaped….3 cuneiforms, heads of metatarsals

Intersegmental tiersIntersegmental tiers……

Deep transverse ligament

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Ant.

Post.

med.Lat.

Transverse head of Ad.H

Dorsal interossei

Intersegmental tiers…

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Tie beamsTie beams……

Peroneus longusTibialis posterior

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Functions and mechanics of archesFunctions and mechanics of arches1. Proportional distribution of body weight.

60 lbs

30 lbs30 lbs

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2. Segmented lever action

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3.Protective action

4. Shift of weight distribution

Invertors and evertors

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5. Dynamic and pliable

Foot in weight bearing

Somewhat flattening of arches

Restoration of original contour in non weight bearing

Spring board effect

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A. Flat foot (Pes planus) : loss of arches

Anomalies Anomalies

Normal foot

Flat foot

Effects:•Loss of shock absorbing function – liable to trauma•Compression of nerves & vessels of sole- Leads to pain in the forefoot- metatarsalgia

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Pes cavus

Plantar flexion at transverse tarsal joint.

Dorsi-flexion at MTP joint.

Plantar flexion at interphalangeal joint

Pateint walk with highly arched foot- toes are dorsiflexed @MTP joint, plantar flexed @ IP joint- deformity of Claw foot

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Club foot

Primarily of 4 types Talipes equinus

Talipes calcaneus

Talipes varus

Talipes valgus

Talipes equinovarus

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Great toe is adducted towards midline of foot

Cause: Hereditary, high heels, narrow

pointed shoes

Hallux valgus

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Full flexion deformity at proximal interphalangeal joint

Usually affects 2nd / 3rd toeAssociated with hallux

valgus

Hammer toe

March foot- decalcification of neck of intermediate metatarsals in continuous stain- lead to pathological fracture- Observed in soldiers

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