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in DF what does talus do to navicular
- as the talus moves back its head juts up, pushing the navicular up, raising the arch.
- PF in turn lowers the arch.
inf fib goes cranial or caudal in DF?
closed packed pos of talocrual joint?
where is the capsule of the ankle thin and weak
ant and post -- this allows movement, and the ligs of the dist tib/fib, talocrural, and subtalar joints support the capsule
on toe-off during gait the ligs on plantar foot are stretched and hold the arch of the mid foot tight/high
classification of talrural joint
components of deltoid lig from post to ant
- post tibiotalar
- tibial calaneal
- ant tibial-navicular
and the deep deltoid lig in front - ant tibiotalar
function of deltoid lig
- check eversion and valgus forces
- limit PF and DF at endranges
which lig is most often sprained?
anterior talofibular lig (it's a segment of the lat collateral lig) that checks PF
3 segments of the lat collateral lig, and which checks what?
- anterior talofibular lig: checks PF
- calcaneofibular lig: checks inv
- posterior talofibular lig: checks DF
main function of the lateral collateral lig
check varus forces, but parts of it check PF, inv, and DF
DoF of talocrural joint
- 1 - PF and DF
- but... because of tibial torsion you kind of get some rotation
inv/ev happens at which joint?
fib goes where in df?
cranial, and the distal end abducts and glides post (IR)
talocrural distraction is to increase __?
ant and middle facets on talus are convex, and the post is...?
- concave on the talus
- each has a matching part on the calcaneus
tarsal tunnel is where?
between ant/mid and post articulations of the talus and calcaneus
interosseus talocalcaneal lig is where? does what?
runs thru tarsal tunnel, holds bones in the middle so they can in/evert, checks pronation
talocalcaneal resting pos
- 10 degrees pf
- midway btwn sup and pro
talocalcaneal close-packed pos
capsular pattern of talocalcaneal joint
- inversion > eversio
- sup > pro
endfeel of hindfoot motions
talocrural joint distraction, how?
- pt supine
- PF to 10 degrees, foot off edge of table
- fixate lower leg to table w belt or firm grip
- lean backward and distract talus from tib and fib, grasping udner both malleoli
- useful for assessment and treatment for limited DF
talocrural joint distraction - moves which bone from which, helps w what motion?
- pulls talus from tib/fib
postioning for talocrural ant/post glides
- pt supine w knee flexed, heel on table, PF to 10 degrees
- stabilize around foot, near calcaneus
- mobilize distal tibia
in talocrural ant/post glide, by moving the talus ant you accomplish what?
- relative post glide of talus
- helps w DF
talocrural glide for PF?
push tibia post -- this relatively pushes talus ant --- helps w PF
talocrural ant post glide w pt supine and you pushing/pulling on distal tib is for assessment. how to treat??
- To treat w ant glide: get the pt prone, ankle in resting pos, foot off table
- stabilize distal tib fib with one hand, press into ant distraction with web space of hand on post talus (just distal to malleoli)... helps w DF
- Hands shoudl be real close
- to do post glide: pt supine (can flex knee to 90), resting pos in ankle, stabilize tib/fib, mobilize w web space over ant talus ... helps w DF
talocalcaneal-navicular joint is what kind of joint?
ball and socket
subtalar joint is what?
location of sustentaculum tali
med and ant to med malleolus
lateral talocalcaneal lig, posterior talocalcaneal lig, lig cervicis, interoseus talocalc lig are in what joint?
subtalar closed packed pos
DF and sup
accessory motions of talocrural joint
- long axs ext (traction)
- ant post glide
movements of subtalar joint
- talar rock
- talar tilt -med and lat
how to do subtalar joint distraction w pt supine
- pt supine, ankle DF (held there w yr trunk against the forefoot)
- stabilize talus by holding ankle mortise (tib/fib)
- cup hand around calc
- lean back to distract
- do this ro test or treatment
how to do subtalar joint distraction (treatment) w pt prone
- dorsum of foot on bed
- stabilize lower leg if necessary to achieve resting pos
- mobilize calcaneus inf to distract it from the talus
- *keep forearm in line w tibia (I guess of stabilizing arm)
How to do the talar-rock?
- pt supine, foot in resting pos
- stabilize talus by holding mortise
- cup hand around calc
- scoop subtalar joint away from mortise to distract and rock talus - diff from distraction ...dunno how
how to do the subtalar joint varus and valgus tilt
- pt supine, hip/knee flexed to 90, slight IR
- stabilize distal thigh agains yr body with yr arms (you're beside it, hugging it)
- mobilizing hand grasps around calcaneus, moving it med and lat
- for valgus, stabilize above the sustentaculum
what glide mustn't you do for calcaneus
midfoot (midtarsal) joints
and they're all synovial
which bones are at the cuneonavicular joint?
nav and all three cunes
bones of the midfoot
- 3 cuneiforms
why is the med arch more pliable than the lat arch?
med has 3 cuneiforms while lat has a single cuboid
avulsion of base of 5th metatarsal
Lis Frank fracture
base of 2nd metatarsal (fragile bc it's the longest)
calcaneus - cuboid joint is in line with///
talo - navicular line
midfoot's talocalcaneonavicular joint - type? degrees of freedom? close packed pos?
- ball and socket synovial
3 ligs of the talocalcaneonavicular joint
- dorsal talonavicular
- plantar calcaneonavicular (spring lig)
capsular pattern of midfoot
DF > PF > add > med rot
When standing, and you pull talus into DF, the navicular is going into PF grade positioning in relation to the talus. – pulling the arch up. (navicular keystone)