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ANKLE Divisions of the Foot Hindfoot: Talus. Calcaneus. Midfoot: Navicular. Cuboid. Cuneiforms. Forefoot: Metatarsals. Phalanges. Ankle Joints and Ligaments Superior and inferior tibiofibular joints: Superior: Synovial plane joint with a capsule. Inferior: Syndesmosis: Posterior tibiofibular ligament. Anterior tibiofibular ligament. Crural tibiofibular interosseous ligament. Ankle Joints and Ligaments Talotibial (talocrural): Most congruent joint in the body. Synovial hinge joint. Axis: Toe out stance (= normal tibial torsion). Pathological: external/internal tibial torsion. Ankle Joints and Ligaments Movements: Dorsiflexion = increased toe out. Plantarflexion = decreased toe out. Mostly occur in sagittal plane. Ankle Joints and Ligaments Talotibial (talocrural): Mortise and tenon joint. Mortise: Fibular malleolus. Tibial malleolus. Distal end of tibia. Tenon: Head of talus. Ankle Joints and Ligaments Talotibial (talocrural): Ligaments: Medial collateral = deltoid: Tibionavicular. Tibiocalcanean. Anterior tibiotalar. Posterior tibiotalar. Ankle Joints and Ligaments Talotibial (talocrural): Ligaments: Lateral collateral (weakest of the collaterals): Anterior talofibular. Posterior talofibular. Calcanefibular. Ankle Joints and Ligaments Talocalcaneal (subtalar): Very stable. Uniaxial, triplanar. Ankle Joints and Ligaments Talocalcaneal (subtalar): Three surfaces: Posterior: Concave facet on talus with convex facet on calcaneus. Anterior: Convex facets on body and neck of talus. Concave facets on calcaneus. Ankle Joints and Ligaments Talocalcaneal (subtalar): Tarsal tunnel: Nonsynovial but with ligament: Talocalcaneal ligament. Ankle Joints and Ligaments Talocalcaneal (subtalar): Movements: Inversion: Adduction (vertical axis). Supination (longitudinal axis). Plantarflexion (coronal axis). Eversion: Opposite inversion. Ankle Joints and Ligaments Talocalcaneal (subtalar): Ligaments: Interosseous talocalcaneal. Posterior and lateral talocalcaneal ligaments. Ankle Joints and Ligaments Talocalcaneonavicular: Talocalcaneal + talonavicular: Movements: Inversion. Eversion. Ankle Joints and Ligaments Talocalcaneonavicular: Ligaments: Calcaneonavicular (spring) ligament: From sustentacular tali to inferior navicular. Continuous medially with deltoid ligament. Continuous laterally with medial band of bifurcate ligament. Helps to maintain medial longitudinal arch. Ankle Joints and Ligaments Calcaneocuboid: Triplanar. Ligaments: Plantar calcaneocuboid (short plantar). Long plantar (most important). Ankle Joints and Ligaments Transverse tarsal: = talonavicular + calcaneocuboid. Adds to inversion-eversion range. Compensates forefoot for hindfoot eversion. Keeps distal foot inverted with lateral surface in contact with the ground while the hindfoot is everted. Retinacula Superior/inferior extensor retinacula: Localized thickenings of anterior crural fascia. Bind down tendons of: Tibialis anterior. Extensor hallucis longus. Extensor digitorum longus. Peroneus tertius. Retinacula Superior/inferior extensor retinacula: Covers: Deep peroneal nerve. Anterior tibial artery. Inferior retinaculum is “Y”-shaped. Retinacula Flexor retinaculum: Localized medial thickening of crural fascia. Binds down tendons of: Flexor hallucis longus. Flexor digitorum longus. Tibialis posterior. Covers: Tibial nerve. Posterior tibial artery. Retinacula Peroneal (fibular) retinaculum: Localized thickenings of lateral deep fascia. Binds down tendons of: Peroneus (fibularis) longus. Peroneus (fibularis) brevis. Plantar Arches Longitudinal: Medial. Lateral. Pathologies: Pes cavus. Pes planus. Plantar Arches Support ligaments: Plantar calcaneonavicular (spring): Primary support for medial longitudinal arch. Long plantar: Primary support for lateral longitudinal arch. Plantar Arches Support ligaments: Plantar aponeurosis. Plantar calcaneocuboid (short plantar). Marginal abductors.