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EXAMINATION OF THE FOOT AND ANKLE

EXAMINATION OF THE FOOT AND ANKLE. Dr. Mohammed Zaheer Dalati Senior Registrar. Department of Orthopaedics College of Medicine King Khalid University Hospital. Objectives. Review anatomy of Foot and Ankle. Discuss key history Hands on exam

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EXAMINATION OF THE FOOT AND ANKLE

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  1. EXAMINATION OF THEFOOT AND ANKLE Dr. Mohammed Zaheer Dalati Senior Registrar Department of Orthopaedics College of Medicine King Khalid University Hospital

  2. Objectives • Review anatomy of Foot and Ankle. • Discuss key history • Hands on exam • Discuss cases concerning common injuries of the Foot and Ankle

  3. Anatomy

  4. Anatomy

  5. Anatomy

  6. Anatomy

  7. Anatomy

  8. Anatomy

  9. Anatomy

  10. History • Onset • Duration • Mechanism • Swelling / Ecchymosis • Ambulation • Hx of previous injury

  11. 2 PARTS: 1- ERECT POSITION. 2-SUPINE POSITION.

  12. Inspection. Palpation. Movements. Special tests.

  13. INSPECTION OF THE PATIENT’S GAIT: Evaluation of the walking cycle GAIT ANALYSIS

  14. STANCE PHASE 65% • Contact Period - heel strike to forefoot loading • Midstance Period - forefoot loading to heel raise • Propulsive Period - heel raise to toe off • SWING PHASE 35%

  15. Stance phase GAIT ANALYSIS

  16. Trendelenburg gait

  17. Tip-toe walking

  18. Foot drop walking

  19. Spastic gait

  20. Intoeing/Out toeng gait

  21. Antalgic gait

  22. Inspection in standing position

  23. INSPECTION: POSTERIOR HEEL STANDING

  24. FOOT SHAPE

  25. ALL THE TOES SHOULD BE IN GROUND CONTACT IN W.B.(stability of the foot on the ground)

  26. INSPECTION: of the L.L Any asymmetry of length, rotational problem, or mal alignment of the lower limbs.

  27. INSPECTION: - Deformity, swelling, skin changes, muscle wasting, asymmetry of length, abnormal position…. INSPECT ALL ARROUND

  28. INSPECTION: PLANTAR SKIN callosity

  29. Palpation: Bone and joints Soft tissues

  30. Anatomical landmarks: -Medialmalleolus, lateral malleolus, Achilles tendon, calcaneal tuberosity, peroneal tendon, tibialis posterior tendon, tibialis anterior tendon, plantar fascia, base of 5th metatarsal, 1st MP joint, metatarsal heads……..etc

  31. PALPATION: Tenderness, swelling, deformity…. Knowing the anatomy:

  32. MOVEMENTS: Ankle: -dorsiflection -plantar flection. Subtalar: -inversion -eversion. Midtarsal: -pronation -supination Tarso-metatarsals: move the metatarsals one by one. Toes:

  33. Ankle movements:

  34. SUBTALAR: MOVEMENT: MOVE THE HEEL: Inversion---eversion

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