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Injuries to the Lower Leg, Foot and Ankle

Injuries to the Lower Leg, Foot and Ankle. Lower Leg Injuries. NEXT PICTURE IS GRAPHIC!!. Caution! Graphic Pictures!. Ankle Injuries. Mechanisms of Injuries. Inversion - bony stability is greater medially than laterally - fibula extends more distally than tibia – prevents eversion

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Injuries to the Lower Leg, Foot and Ankle

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  1. Injuries to the Lower Leg, Foot and Ankle

  2. Lower Leg Injuries NEXT PICTURE IS GRAPHIC!! Caution! Graphic Pictures!

  3. Ankle Injuries

  4. Mechanisms of Injuries • Inversion - bony stability is greater medially than laterally - fibula extends more distally than tibia – prevents eversion - occur from running on uneven surfaces or cutting

  5. Plantar Flexion - Usually sprain ankle when in plantar flexion. - Ankle is unstable in this position

  6. Eversion - usually due to a planted foot that receives a lateral force - stepping in a hole - higher incidence of fractures

  7. Lateral Ligament Sprain • Most common ankle injury • MOI = Inversion and plantar flexion • Ankle sprain wrapping: http://www.youtube.com/watch?v=uAfMArBFBNI&feature=related

  8. Anterior Talofibular Ligament (ATF) is injured first. (mild sprain) • The Calcaneofibular Ligament (CF) is injured in more severe sprains • The Posterior Talofibular Ligament is injured in the most severe sprains

  9. INVERSION ANKLE SPRAIN

  10. Ankle inversion

  11. Medial Ligament Sprain(Deltoid Ligament) • Often associated with fractures of lateral malleolus • Eversion Sprain • If force continues, the deltoid ligament is stretched and torn

  12. The Deltoid Ligament

  13. Peroneal Tendon Injury • Can occur when lateral ankle ligaments are injured • Common problems are dislocation of tendons over lateral malleolus or peroneal tendonitis

  14. Lower Leg

  15. Contusions • Shin contusion - little soft tissue to absorb force - Periosteum receives impact - MOI : Direct blow

  16. Compartment Syndrome NEXT PICTURE IS GRAPHIC!! • Increased pressure in compartments compromises muscles, nerves, or blood vessels • 4 compartments in lower leg • Caused by overuse or direct contact • Athlete has pain, decreased sensation over foot, possible foot drop

  17. Fasciotomy

  18. Muscle Strain • Calf is most affected (usually at gastroc-achilles junction) • MOI – violent contraction excessive dorsiflexion overuse

  19. Achilles Tendonitis NEXT PICTURE IS GRAPHIC!! • Inflammation of the Achilles • MOI – overuse, microtearing of tendon • Signs – pain, point tender, crepitus, swelling

  20. Achilles Tendon Tear NEXT PICTURE IS GRAPHIC!!

  21. Muscle Spasm • Calf usually affected • MOI – fatigue, dehydration • Treatment – direct compression, gradual stretch, ice, rehydrate

  22. Leg Fractures • Direct blows or indirect trauma • Fibular fracture more common • Deformity, pain, unable to bear weight (Fibula?)

  23. NEXT PICTURE IS SORTA GRAPHIC!!

  24. Stress Fractures An incomplete break in a bone occurring after prolonged repetitive exercise

  25. Stress Fractures (con’t) • Signs and Symptoms - intense pain - point tender - more painful after activity - + percussion test

  26. Medial Tibial Stress Syndrome • “shinsplints” • Pain along medial border of the tibia • Usually with novice runners – well conditioned runners usually due to mechanical abnormalities

  27. Shin Splints

  28. Causes: - running on hard surfaces - Overuse - Muscle imbalance - Tight Achilles

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