Ankle and Foot Complex

Foot & Ankle - Functions

Two Principal demands -:

 Stability
1. Provide a stable BOS in various
weight bearing postures with
minimal muscle effort.
2. Acts as a lever for effective push-
off.
 Mobility
1. Provide a mechanism for
rotation of more proximal joints and
also dampening those rotations.

2. Provide shock absorption as foot

hits the ground.

3. Provide flexibility to adapt to

uneven terrain.
Thus to meet these demands the ankle
and foot contain -:

 28 bones

 25 component joints

 more than 100 muscles, tendons and

ligaments

 a network of blood vessels, nerves,

skin, and soft tissue.
Bones
Divided into three
sections -:

 Hindfoot or
Rearfoot

 Midfoot

 Forefoot
Movements
 Abduction and Adduction
 Pronation =
Dorsiflexion+Eversion+Abduction
 Supination =
Plantarflexion+Inversion+Adduction
 Valgus and Varus
JOINTS
Hindfoot Joints

 Ankle Joint Complex-:

- Distal Tibiofibular joint
- Talocrural or Ankle joint

 Talocalcaneal or Subtalar
Joint
 Proximal Tibiofibular Joint
 Synovial Plane joint.
 Supported by-:
- Articular capsule
- Anterior Tibiofibular
ligament
- Posterior Tibiofibular
ligament
- Synovial membrane
 Movements-:
- Superior/ Inferior
Sliding of Fibula
- Fibular Rotations
Ankle Joint Complex
A complex of two joints-:

 Distal Tibiofibular joint

forming the Ankle
Mortise

 Talocrural joint
Distal Tibiofibular Joint
 Syndesmotic Joint
 No capsule

 Forms Ankle Mortise

 Supported by-:

- Anterior Inferior
Tibiofibular ligament
- Posterior Inferior
Tibiofibular ligament
- Inferior Transverse
ligament
- Interosseous ligament
- Interosseous membrane
Talocrural (Ankle) Joint
 Synovial joint of Hinge variety.
 Formed by Ankle Mortise and
Talus.
 Movements-:
Plantarflexion
Dorsiflexion
Surface Anatomy of Talus
 Supported by-:
- Articular Capsule
- Medial Collateral
Ligaments or
Deltoid Ligament -
- Tibionavicular
ligament
- Tibiocalcanean
ligament
- Posterior
Tibiotalar ligament
- Anterior
Tibiotalar ligament
 - Lateral Collateral
ligaments-:
- Anterior Talofibular
ligament
- Posterior Talofibular
ligament
- Calcaneofibular
ligament
 Retinaculae
Retinaculae of Ankle Joint
Subtalar Joint
 Synovial joint formed by Talus &
Calcaneus
 Contains two joints-:

- Posterior joint – Talocalcanean

joint or Anatomic Subtalar joint
- Anterior joint – Talocalcaneal
part of Talocalcaneonavicular
joint
 Movements

- Eversion
- Inversion
Surface Anatomy of Calcaneus
Anatomic Subtalar Joint
 Synovial joint
 Supported by-:

- Articular Capsule
- Anterior Talocalcaneal ligament
- Posterior Talocalcaneal ligament
- Medial Talocalcaneal ligament
- Lateral Talocalcaneal ligament
- Interosseous Talocalcaneal
ligament
- Cervical ligament
Midfoot (Midtarsal Joints)
Transverse Tarsal Joints - :
 Talocalcaneonavicular joint
 Calcaneocuboid joint
Distal Intertarsal Joints - :
 Cuneonavicular joint
 Cuboideonavicular joint
 Intercuneiform joints
 Cuneocuboid joint

Chopart’s joint – joints between talus-

navicular, calcaneus-cuboid.
Talocalcaneonavicular Joint
 Synovial Joint of Ball and
Socket type.
 Movements – Gliding &
Rotation
 Formed by –
- Anterior articulation
of the subtalar joint &
- Talonavicular joint
Surface Anatomy of Navicular
Supported by-:
- Articular capsule
- Spring or Plantar
Calcaneonavicular ligament
- Medial limb of Bifurcated
ligament
- Dorsal Talonavicular lig.
Calcaneocuboid Joint
 Saddle joint – being reciprocally concave/
convex in both side to side and up and
down movements.
 Supported by-:
- Articular capsule
- Lateral limb of Bifurcated ligament
- Long Plantar ligament
- Short Plantar or Plantar Calcaneocuboid
lig.
- Dorsal Calcaneocuboid ligament
 Movements – Gliding with Conjunct
rotation
Surface Anatomy of Cuboid
 Distal Intertarsal Joints
Cuneonavicular Joint Cuboideonavicular
 Plane Synovial joint Joint
 Movements-: Slight  Fibrous Joint
gliding and rotation  Movements-: Slight
 Supported by-: gliding and rotation
- Dorsal Ligaments  Supported by-:
- Plantar Ligaments - Dorsal Ligaments
- Synovial Membrane - Plantar Ligaments
- Interosseous Ligament
- Synovial membrane
Intercuneiform and Cuneocuboid
Joints
 Plane Synovial Joints
 Movements-: Slight Gliding and
Rotation
 Supported by-:
- Dorsal Ligaments
- Plantar Ligaments
- Interosseous Ligaments
- Synovial Membrane
Surface Anatomy of Cuneiforms
Forefoot Joints
 Tarsometatarsal joints or Lisfranc’s
joints

 Intermetatarsal joints

 Metatarsophalangeal joints

 Interphalangeal joints
Tarsometatarsal Joints
 Plane Synovial Joints
 Movements – Gliding

 Supported by-:

- Articular Capsule
- Dorsal Ligaments
- Plantar ligaments
- Interosseous Ligaments
- Synovial Membrane
 Intermetatarsal Joints
 Plane Synovial Joints
 Movements – Gliding

 Supported by -:

- Articular capsule
- Dorsal Ligaments
- Plantar Ligaments
- Transverse Metatarsal
Ligament
- Interosseous Ligaments
- Synovial Membrane
Surface Anatomy of Metatarsals
Metatarsophalangeal Joints
 Condyloid Synovial
Joints
 Movements -:

- Flexion / Extension
- Abduction / Adduction
 Supported By -:

- Articular Capsule
- Plantar Ligaments
- Collateral Ligaments
- Extensors Tendons
support Dorsally
Interphalangeal Joints
 Hinge Variety of
Synovial joint
 Movements -:

- Flexion / Extension
 Supported By-:

- Articular Capsule
- Plantar ligaments
- Collateral Ligaments
- Extensor Tendons
support Dorsally
Muscles of Foot And Ankle
 Extrinsic Muscles -:
- Anterior Compartment Muscles
- Posterior Compartment Muscles
- Lateral Compartment Muscles
 Intrinsic Muscles
Extrinsic Muscles
 Anterior Compartment Muscles

Extensor Extensor Tibialis

Digitorum longus Hallucis Longus Anterior
 Posterior & Lateral Compartment

Gastrocnemius Soleus Plantaris

Flexor Flexor Tibialis
Digitorum longus Hallucis Longus Posterior
Peroneus Peroneus Peroneus
Longus Brevis Tertius
Intrinsic Muscles
Divided into four layers – :
Layer 1 – Most superficial
Layer 4 – Most deep

Superficial to the muscles is

a covering called the
Plantar Fascia.
Plantar Fascia
Muscles of sole – 1st Layer
Muscles - 2 layer
nd
Muscles – 3 Layer
rd
Muscles – 4th layer
Arches of Foot
Classification-:
 Longitudinal -:

- Medial
- Lateral
 Transverse

- Anterior
- Posterior
Medial Longitudinal Arch
Lateral Longitudinal Arch
Transverse Arch
Maintenance of Arches
Bony Factor
Intersegmental Ties
Muscles – 4th layer
Tie Beam
Slings
Medial Longitudinal Arch
Lateral Longitudinal Arch
Transverse Arch
Functions of Arches

 Distribute weight to the weight-

bearing areas of the sole.
 Act as Springs
 Act as Shock-absorbers
 Protect soft tissue against
pressure
THANK YOU