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ankle

anatomy

The tarsal root includes all the structures that are located between the fibula, the tibia and the toes. These include 7 tarsal bones, which can be divided into two rows, but also several joints, as well as the entire ligament and muscular system in this region.

The tarsal bones can be divided into a closer to the trunk, the so-called " proximal " and a " distal " bone row located near the toes. The proximal row consists of the talus " Talus " and the telangiectus " Calcaneus ". The distal row contains several small bones. These include the scaphoid " navicular bone", the cube bone "cuboid bone" and three cuneiform bones " Ossa cuneiforme ", which are once again divided into a middle, an outer and an intervening. The heel bone is probably the most prominent, since it forms the classic heel, is the largest bone of the foot and has to lift a large part of the entire body weight.

All tarsal bones are tightly interconnected by tight ligaments, which stabilize the two ankle joints above all and allow the upright, secure stand. The protrusion formed by the heel bone is also called " tuber calcanei ". Among other things, it has a function as a point of attachment of the Achilles tendon, which is why this region is referred to as the Achilles heel. The Achilles tendon itself is the approach of a multi-part muscle, which rises from the thigh and forms the bulk of the muscular calf. Its function is to stretch the foot as a whole.

For the movements of the foot, especially the two hocks are important. Due to the high weight load and stability requirements, the joints are very firmly secured by ligaments, which accordingly limits the mobility in comparison to the hand. In the upper ankle joint, the talus " Talus " is completely surrounded by the upper and left and right by the two lower leg bones, the fibula " Fibula " on the outside and the tibia " Tibia " in the middle. Palpable and visible from the outside is in the form of the two ankles. The result is that the main movement in this joint is only in stretching or putting on the foot (" extension " and " flexion "). From bone to bone, different ligaments, which have lateral stabilization, function on the inside and outside. These are called summarized only the inner band " ligamentum collaterale mediale " and outer band "Ligamentum collaterale lateralale".

The lower ankle is subdivided once again into a front lower and a rear lower ankle joint. In the posterior lower ankle, the heel bone and anklebone are articulated, whereas in the anterior ankle, the proximal tarsal bones form a joint with the navicular bone. Since this joint extends over several bones and is anatomically divided into two individual joint capsules, this must also be fixed and stabilized by a plurality of tighter ligaments. The lower ankle allows limited execution of " supination and pronation movements ." This means that you can lift the middle and outer edge of the foot.

Figure ankle

Figure left foot: Skeleton from the right side (A) and from the top (B)
  1. Toe end member - phalanx distalis
  2. Toe middle link - phalanx media
  3. Toe element - Phal. proximalis
    (1st - 3rd toe bones - Phalanges)
  4. Metatarsal bones -
    Os metatarsi
  5. Inner sphenoid -
    Medial cuneiform
  6. Middle sphenoid -
    Os cuneiforme intermedium
  7. Outer sphenoid -
    Os cuneiforme lateral
  8. Cuboid - Os cuboideum
  9. Scaphoid - Os naviculare
  10. Anklebone - Talus
  11. Anklebone Scroll - Trochlea tali
  12. Heel bone - calcaneus
  13. Projection on the 5th metatarsal bone - Tuberositas ossis metatarsalis quinti (V)

An overview of all pictures by Dr-Gumpert can be found at: medical pictures

Fußwurzelbruch

With the large number of existing tarsal bones, fractures, so-called fractures, can occur under certain conditions. Such a break can be differentiated according to different criteria. By definition, a fracture divides a contiguous single bone into at least two parts. Almost always such a break is associated with pain and a functional limitation. Other aspects may play a role in the assessment, such as the cause of the fracture, the extent and location of the fracture, or whether there is an open fracture (whether an open wound has been caused by bone fractures).

The two most common causes of fracture of the tarsus are a force, for example, in the course of an accident, and a metabolic weakening of the bones, such as may occur in age-related osteoporosis, which leads to a normal (physiological) burden leads to a fracture. Such a fracture can obviously be manifested by visibly abnormal bone positions. Otherwise, it can be suspected of typical localized pain, especially when performing movements of the involved bone, as well as swelling, pressure pain or bruising. When describing the course of the accident and these symptoms, an X-ray of the affected area is usually taken for safe diagnosis. Especially at the tarsal root it is essential to scan several anatomical levels of the foot, as often not all bones and fractures can be seen from one angle only. In addition, a high-resolution image can provide more information through a CT or MRI.

If such a fracture has been diagnosed, depending on the position of the bone fragments, the doctor will decide on further therapeutic measures. An operation may be required. The goal here is to bring the bone fragments within the tarsal root back to their original place and connect them there by wires or screws. The complete healing of the bone parts takes several weeks. Meanwhile, it is important to relieve and calm the fracture site while maintaining and exercising the function of the joints and muscles. Relief often requires a plaster cast or a splint, usually in combination with walking aids.

injury

Because of the heavy weight that our feet are physiologically exposed to every day, they are predestined for injuries and traumas that cause an accident.

In addition to the fractures of the tarsal bones described above, the "Umknicktraumata" a frequent injury. The classic buckling of the foot in or out can occur at any time in everyday life or often in many sports. Particularly legged and jump-heavy sports are high risk factors, for example football, basketball or handball. If it happens you should immediately relieve the foot. At the same time, one can start to cool the affected area, put it up and push it lightly to counteract the onset of swelling. In each case, a doctor should be consulted to estimate the extent of the injury. This uses ultrasound, an X-ray, CT or MRI. Especially the MRI can provide accurate information about the damage to the tissue or involvement of the bone.

Often, there is a stretch or tear in one of the tight bands of the upper ankle, the " collateral ligaments ." The outer ligament on the foot is particularly frequently affected, since a so-called " supination trauma ", a turning over to the outside, is much more common than a " pronation trauma ". However, the treatment is conservative in most cases by sparing the area, often supplemented by bandages or splints. However, an operative supplement may be necessary, for example, if the connection of the two bones of the lower leg, the " syndesmosis ", is also injured. In many cases, such an injury sounds inconsequential. However, there is also the risk that a lasting instability will be left behind, which leads to the fact that a turning over can become more and more frequent.

You might also be interested in: Achilles heel

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