Foot and Ankle Anatomy, Ligaments, Injuries & Fractures

alocrural joint (ankle)

Primary movements: .______________

Formed by the tibia, fibula, and talus.

Important for walking, running, landing, and jumping.

dorsiflexion and plantarflexion

Subtalar joint

Primary movements: ________________.

Formed by the talus and calcaneus.

Helps the foot adapt to uneven surfaces.

inversion and eversion

Midtarsal joints

Include the _________________________ joints.

Allow the foot to adapt between a flexible and a more rigid lever during walking.

talonavicular and calcaneocuboid

Tarsometatarsal (TMT) joints

Connect the tarsal bones to the metatarsals.

The ______________ is a key stabilizer of the medial midfoot.

Lisfranc ligament

Lateral ankle ligaments

__________________________(ATFL): commonly injured in inversion with plantarflexion

________________________(CFL): helps stabilize the ankle and subtalar region.

_________________________(PTFL): typically involved in more severe ankle injuries.

Anterior talofibular ligament

Calcaneofibular ligament

Posterior talofibular ligament

Medial ankle ligament

_______________: resists excessive eversion.

Deltoid ligament

Important foot-supporting ligaments

________________: supports the lateral longitudinal arch.

_______________(plantar calcaneonavicular ligament): supports the talar head and medial arch.

_______________: has calcaneonavicular and calcaneocuboid components.

______________: connects the medial cuneiform to the base of the second metatarsal.

Long plantar ligament

Spring ligament

Bifurcate ligament

Lisfranc ligament

Static versus dynamic support

_____________: bones, ligaments, plantar fascia, and joint capsules.

_______________: tendons and muscles, including tibialis posterior, tibialis anterior, peroneals, intrinsic foot muscles, and the long toe flexors.

Static structures

Dynamic structures:

Three common toe anomalies

________________: lateral deviation of the great toe, often associated with a bunion.

______________: flexion deformity, typically at the PIP joint.

_____________: extension at the MTP joint with flexion at the PIP and DIP joints.

Hallux valgus

Hammertoe

Claw toe

plantar midfoot bruising and midfoot pain after a twisting injury should raise strong suspicion of a ______________

Lisfranc injury

________________________-

Also called pump bump.

A bony prominence at the posterosuperior calcaneus.

Tight or rigid-backed shoes can irritate the surrounding bursa and Achilles insertion.

Management: footwear modification, heel padding, load modification, and rehabilitation as indicated. Surgery is considered only for persistent symptoms despite appropriate conservative treatment.

Haglund deformity

A young athlete (ages 8-15) with gradual-onset heel pain that worsens during running and jumping and is tender near the Achilles insertion is highly suggestive of ______________________

Sever disease (calcaneal apophysitis).

ifth metatarsal fractures

_______________: occurs in the proximal fifth metatarsal metaphyseal-diaphyseal junction, distal to the tuberosity.

_______________ (often called a dancer's fracture in some teaching materials): occurs at the tuberosity, commonly due to traction during an inversion injury.

_____________: may be acute or stress-related.

Management: protect from weight-bearing and arrange imaging and assessment. Immobilization and surgical decisions depend on fracture location, displacement, healing risk, and athletic demands.

Jones fracture

Avulsion fracture

Shaft fracture

the diagnosis determines the restrictions. A routine sprain may progress with symptoms and function, whereas a __________________________________ injury must not be treated as an ordinary sprain or cleared for play solely because the athlete can walk.

suspected fracture or Lisfranc

Which ligament is most commonly injured in a lateral ankle sprain?

A. CFL

B. ATFL

C. PTFL

D. Deltoid ligament

B

. What is the primary function of the deltoid ligament?

A. Resist inversion

B. Resist excessive eversion

C. Prevent toe extension

D. Stabilize the knee

B

Which two bones form the ankle mortise around the talus?

A. Fibula and calcaneus

B. Tibia and fibula

C. Tibia and navicular

D. Talus and calcaneus

B

. A high ankle sprain most commonly involves which structures?

A. ATFL and CFL

B. Spring ligament

C. Distal tibiofibular syndesmosis

D. Plantar fascia

C

5. What is the classic mechanism of a high ankle sprain?

A. Inversion with plantarflexion only

B. External rotation with dorsiflexion

C. Direct blow to the heel only

D. Toe hyperextension

B

. Which ligament resists inversion and contributes to subtalar stability?

A. CFL

B. Tibionavicular

C. AITFL

D. Spring ligament

A

7. Which injury is associated with a spiral fracture of the proximal third of the fibula and syndesmotic disruption?

A. Jones fracture

B. Maisonneuve fracture

C. Bimalleolar fracture

D. Talus fracture

B

What does a bimalleolar fracture involve?

A. Both ends of the fifth metatarsal

B. Medial and lateral malleoli

C. All three malleoli

D. Only the posterior malleolus

B

Which finding is part of the Ottawa Ankle Rules for ankle radiographs?

A. Any bruising on the toes

B. Tenderness along the posterior edge or tip of either malleolus

C. Pain only during running

D. A positive anterior drawer test

B

An athlete has pain above the ankle, tenderness over the AITFL, and pain with external rotation. What is the most likely injury?

A. Plantar fasciopathy

B. High ankle sprain

C. Turf toe

D. Isolated ATFL sprain

B

Which ligament belongs to the medial deltoid complex?

A. Anterior talofibular

B. Calcaneofibular

C. Tibionavicular

D. Bifurcate

C

12. Persistent deep ankle pain, swelling, and catching after an ankle sprain suggest which possible complication?

A. Osteochondral lesion of the talus

B. Hammertoe

C. Cuboid syndrome only

D. Achilles rupture in every case

A

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