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Examination of Foot and Ankle in a Child
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Nirmal Raj Gopinathan, Mandeep Singh Dhillon, Pratik M. Rathod
Next, examine the malleoli; normally, the lateral malleolus is about a centimeter lower and posterior to the medial malleolus. If both malleoli are at the same level, it indicates an ankle valgus alignment (Figure 11.10). Ankle pathologies with gross effusion present with swelling all around the ankle joint. Tendon sheath swellings are usually longitudinal and appear along the long axis of the leg and foot, extending along the sheath beyond the joint level. Also, look for the fossae in front of the malleoli, which get obliterated in case of an ankle swelling. Posteriorly, look for the normal shallow concavity on either side of the tendoachilles. Inspect for any swelling along with the insertion of the tendoachilles into the calcaneal tuberosity, indicating enthesitis. Compare the calf muscle bulk with the normal side and inspect for the prominence of the tendoachilles. The heel should be observed for the following findings and should be compared with the normal side to find out whether it is broadened enlarged, or high riding.
A to Z Entries
Published in Clare E. Milner, Functional Anatomy for Sport and Exercise, 2019
The talus is common to both the ankle and the foot, forming the distal part of the ankle joint and the proximal part of the subtalar joint. The distal ends of the tibia and fibula, the malleoli, form the proximal part of the ankle joint and can be used to approximate the ankle joint axis in vivo. The ankle joint axis passes just distal to the tips of the malleoli. According to Inman (1976), the ankle joint axis lies, on average, 5 mm distal to the tip of the medial malleolus, and 3 mm distal and 8 mm anterior to the tip of the lateral malleolus.
Diagnostic research
Published in Nicholas Summerton, Primary Care Diagnostics, 2018
In assessing the applicability of clinical indicants one sequence is illustrated by the development of the ‘Ottawa ankle rules’ for acute ankle injuries. In 1992 Stiell et al. undertook a study of 750 emergency department patients over a 5-month period. They surveyed for 32 standardised clinical variables that were compared against a radiographic gold standard in order to develop clinical indicants for malleolar fractures. Such fractures were more likely to be identified among people who had pain near the malleoli and who were aged 55 years or more, had localised bone tenderness of the posterior edge or tip of either malleolus, or were unable to bear weight both immediately after the injury and in the emergency department.23
Repeatability, reproducibility, and agreement of three methods for finding the mechanical axis of the human tibia
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Alexander Simileysky, Maury L. Hull
All methods for finding the center of the talocrural joint were executed using a MATLAB program. Each method started out by loading the full tibia point cloud into the program, then isolating all points that were within 50 mm above the most inferior point on the medial malleolus. The isolated points were plotted in the coronal view, and the points on the medial and lateral edges of the weight-bearing distal articular surface were selected (Figure 2). The medial edge was found at the start of the flat section where the medial malleolus ended, and the lateral edge was found at the end of the flat section where the bone began to curve upward. The coronal center point was computed as the midpoint between the two selected points in the coronal plane and used as a reference for determining which cross-sections would be isolated in the next steps.
Modelling the complexity of the foot and ankle during human locomotion: the development and validation of a multi-segment foot model using biplanar videoradiography
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Jayishni N. Maharaj, Michael J. Rainbow, Andrew G. Cresswell, Sarah Kessler, Nicolai Konow, Dominic Gehring, Glen A. Lichtwark
We aligned the coordinate system of each rigid body such that when the model is in the anatomical position, the x-direction pointed anteriorly, the y-direction pointed superiorly and the z-direction to the right. The talus coordinate system was located at the midpoint between the medial and lateral malleoli markers, at vertical centre of the bone. The calcaneus coordinate system was located at the midpoint between the medial and lateral calcaneal markers, at vertical centre of the bone. The midfoot coordinate system was located at the midpoint between the navicular and fifth metatarsal base at the proximal aspect of the segment. The forefoot coordinate system was located at the second metatarsal base while the coordinate systems for the digits was located at the second proximal phalanx.
Measurement of instantaneous Achilles tendon moment arm and force during the stance phase of running
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Giorgos Krikelis, Matthew T. G. Pain, Laura-Anne M. Furlong
The ATMA curve across the ankle range of motion from the motion analysis/ultrasound data relative to the FHAm intersected with the ATMA profile during walking reported by Rasske et al. (2017) that was measured with a similar method (Figure 6). However, in that study the moment arm was measured relative to the midpoint of the malleoli markers. In contrast to the results from Wade et al. (2019), ATMA relative to the ankle ‘functional’ axis were lower than when calculated relative to the malleoli midpoint in this study. The reasons for such difference are not clear, since the methods used in this study and in Wade et al. (2019) were similar. Part of it could be explained by the fact that the loading conditions were different (running vs. toe raises), as well as subject anatomical variation.