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Ankle Injury Management

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					Ankle Injury Management




           Module J2
Bones and Prominent Boney Features

   Calcaneus
   Talus
   Cuboid
   Navicular
   Cuneiforms
   Tibia
   Fibula
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
Ligaments

   Anterior/posterior tibiofibular- (aka
    syndesmotic ligaments)
   Calcaneofibular-
   Anterior talofibular
   Deltoid
   Peroneal retinaculum
Ligaments
Muscles

   Ant. Tibialis                Peroneus longus
   Flexor hallicus longus       Peroneus brevis
   Flexor digitorum longus      Peroneus tertius
   Posterior tibialis           Gastrocnemius
   Extensor hallicus            Soleus
    longus
   Extensor digitorum
    longus
Other structures

   Anterior tibial artery
   Deep peroneal n.
   Superficial peroneal n
   Posterior tibial n.
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
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
Kleiger’s 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
Tap test

   Tinel’s sign
   Malleolus fx
Injuries and Conditions

   1st° ankle                  Peroneal strain
   2nd° ankle                  Fracture
   3rd° ankle                  Stress fracture
   Sprain- dislocation         Avulsion fracture
   Anterior tibial strain
The End




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posted:10/8/2012
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