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ANKLE JOINT,SUPERIOR & INFERIOR TIBIO-FIBULAR JOINTS
,JOINTS OF FOOT
LEARNING OBJECTIVES
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Describe the Ankle Joint
Discuss the Superior and Inferior Tibio-Fibular Joints
Discuss Sub-talar Joint
Discuss transverse tarsal joint or mid-tarsal joint.
TALOCRURAL JOINT (ANKLE JOINT)
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Type:
- hinge type of synovial joint.
Articular Surfaces: - between inferior ends of
tibia and fibula and superior part of talus.
ARTICULAR SURFACES
Tibia articulates with talus in two places:
(1)Inferior surface forms roof of mortise, which is wider anteriorly than
posteriorly
(2) Lateral surface of its medial malleolus articulates with talus.
 Talus has three articular facets, which articulate with inferior
surface of tibia and malleoli.
 Trochlea of talus is wider anteriorly than posteriorly and slightly
concave side to side.
ARTICULAR CAPSULE
 Fibrous capsule is supported
each side by strong collateral
ligaments (medial or deltoid
lateral ligaments).
on
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Attached superiorly to borders of articular
surfaces of tibia and malleoli.
Attached inferiorly to talus, except antero
inferiorly.
SYNOVIAL CAPSULE
 Synovial capsule of ankle joint lines fibrous capsule.
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Synovial cavity of ankle joint is superficial on each side of tendo
calcaneus.
MEDIAL OR DELTOID LIGAMENT
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Apex of ligament is attached to margins and tip of medial
malleolus.
Broad base fans out and attaches to
three tarsal bones (talus, navicular, and
calcaneus).
Function:
- Strengthens joint and hold calcaneus
and navicular bones against talus.
- Help to maintain medial side of foot
against longitudinal arch.
Deltoid ligament consists of four parts:
Tibio navicular Ligament
Anterior tibio talar Ligament
Posterior tibio talar Ligament
Tibio calcanean ligaments.
LATERAL LIGAMENT OF THE ANKLE
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Attach lateral malleolus to talus and calcaneus.
Three distinct parts of lateral ligament are:
Anterior talo fibular ligaments
Posterior talo fibular ligaments
Calcaneo fibular ligaments.
JOINT STABILITY
 Ankle joint is very strong during dorsi flexion because:
- it is supported by powerful ligaments.
- it is crossed by several tendons.
- tightly bound down by thickenings of deep fascia called retinacula.
- trochlea of talus fills mortise formed by malleoli.
- Anterior part of trochlea forces malleoli of leg bones apart slightly.
ANKLE JOINT MOVEMENTS
• Movements:
- dorsi flexion and plantar flexion.
Movements in plantar flexion:
- rotation, abduction, and adduction.
Movements in dorsi flexion :
- trochlea of talus rocks posteriorly in
three-sided mortise.
- malleoli are forced apart because
superior articular surface of talus is
wider anteriorly than posteriorly.
-Thus, range of plantar flexion is
greater than that of dorsi flexion.
BLOOD & NERVE SUPPLY
Blood Supply:
- Malleolar branches of fibular (peroneal) artery.
- Anterior and posterior tibial artery.
Nerve Supply:
- Tibial nerve.
- Deep peroneal nerve, a division of common peroneal nerve.
TIBIO FIBULAR JOINTS
 Tibia and fibula articulate at their proximal and distal ends.
 Movement at proximal tibio fibular joint is impossible without
movement at distal one.
PROXIMAL (SUPERIOR) TIBIO FIBULAR JOINT
Type:
- plane type of synovial joint between head of fibula and lateral
condyle of tibia.
Articular surface:
- Facet on head of fibula articulates with facet
located postero laterally on inferior aspect of
lateral condyle of tibia.
ARTICULAR CAPSULE
- Fibrous capsule surrounds joint and is attached to margins of
articular facets on fibula and tibia.
- Strengthened by anterior and posterior ligaments of head of
fibula.
- Fibers of these ligaments run supero- medially from fibula to tibia.
SYNOVIAL MEMBRANE
- Synovial membrane lines fibrous capsule.
- Pouch of synovial membrane passing under tendon of popliteus
muscle, known as popliteus bursa.
BLOOD & NERVE SUPPLY
Blood Supply:
- Inferior lateral genicular artery.
- anterior tibial recurrent artery.
Nerve Supply:
- Common peroneal nerve.
- Nerve to popliteus muscle.
DISTAL (INFERIOR) TIBIO FIBULAR JOINT
Type:
- Fibrous joint of syndosmosis type.
- Located between inferior ends of tibia and fibula.
Articular Surfaces:
- Rough, convex, triangular articular area on medial surface of
inferior end of fibula articulates with facet on inferior end of tibia.
LIGAMENTS
Interosseous ligament: - continuous superiorly with interosseous
membrane.
- Forms principal connection between tibia and fibula at this joint
 Strong anterior and posterior tibio fibular ligaments strengthen
distal tibio fibular joint anteriorly and posteriorly.
- Inferior, deep part of posterior tibio fibular ligament is called
transverse tibio fibular ligament.
This strong band closes posterior angle between tibia and fibula.
 Joint Stability:
- This articulation forms a strong union between distal ends of tibia
and fibula.
- Strength of ankle joint is dependent on this union.
 Joint Movement:
- Slight movement of distal tibio fibular joint occurs to accommodate
talus during dorsi flexion of foot at ankle joint.
BLOOD & NERVE SUPPLY
 Blood Suppl y:
- Perforating branch of fibular (peroneal) artery
- medial malleolar branches of anterior and
posterior tibial arteries.
 Nerve Suppl y:
- Deep fibular (peroneal), tibial, saphenous
nerves
SUB TALAR (TALO CALCANEAN) JOINT
- Sub talar (talo calcanean) joint is distal to ankle joint.
- Talus rests on and articulates with calcaneus.
Type:
Synovial joint between inferior surface of
body of talus and superior surface of
calcaneus.
ARTICULAR CAPSULE
- surrounded by an articular capsule.
- attached near margins of articular facets.
- fibrous capsule is weak.
- supported by medial, lateral and posterior talo calcanean and
anteriorly by interosseous talo calcanean ligament.
JOINT MOVEMENTS
 Inversion and eversion:
- main movements at Sub talar joint.
 Gliding and rotation :
- assist with inversion and eversion of posterior part of foot.
TRANSVERSE TARSAL JOINT
 Talo navicular and
Calcaneo cuboid joint are separate joints.
- together they constitute transverse tarsal joint or mid-tarsal
joint.
- extend across tarsus in almost same transverse plane.
TALO NAVICULAR JOINT
Forms between:
- head of talus and socket of posterior surface of navicular bone.
- superior surface of plantar calcaneo navicular ligament ("spring
ligament").
- sustentaculum tali
articular surface of calcaneus.
TALO CALCANEO NAVICULAR JOINT
Type:
-synovial joint of ball and socket type.
- surrounded by a single articular capsule that blends with
interosseous talo calcanean ligament posteriorly.
-Talo calcaneo navicular joint is reinforced dorsally by dorsal talo
navicular ligament.
CALCANEO NAVICULAR LIGAMENT
 Triangular band extends from sustentaculum tali to postero inferior
surface of navicular bone.
 Blends with deltoid ligament medially and forms part of socket for
head of talus.
 Plays an important role in maintaining longitudinal arch of foot.
CALCANEO CUBOID JOINT
Type:
Synovial joint between anterior surface of calcaneus and posterior
surface of cuboid.
Function:
Dorsal calcaneo cuboid ligament and plantar calcaneo cuboid
ligament (short plantar ligament) strengthen capsule of calcaneo
cuboid joint.
MOVEMENTS OF TRANSVERSE TARSAL JOINT
 Inversion and eversion of foot:
- During inversion:
foot is adducted and directed so that its medial border is raised
and its lateral border is depressed.
- During eversion:
foot is abducted and directed so that lateral border is raised and
medial border is depressed.
- Strong medial (deltoid) ligament prevents over eversion of foot.
- Weaker lateral ligaments prevent over inversion of foot.
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