踝关节生物力学 课件.ppt

Anatomy and evaluation of the ankle;Ankle;Tibia胫骨;The Tibia is the medial bone and largest bone of the lower leg.;Fibula腓骨;Fibula---;Talus ;?------ Talus;Talocrural Joint;________________ ________________;Subtalar Joint;calcaneus;Ankle Ligaments;Talus;Post. Tibiofibular Lig.;calcaneus;The deltoid ligament;Tibia;Muscles of the lower leg/ankle;Anterior Compartment;Lateral Compartment ;Posterior Superficial Group;Posterior Deep;Assessing the Lower Leg and Ankle;Observations Postural deviations? Is there difficulty with walking? Deformities, asymmetries or swelling? Color and texture of skin, heat, redness? Patient in obvious pain? Is range of motion normal?;Percussion and compression tests Used when fracture is suspected Percussion test is a blow to the tibia, fibula or heel to create vibratory force that resonates w/in fracture causing pain Compression test involves compression of tibia and fibula either above or below site of concern Thompson test Squeeze calf muscle, while foot is extended off table to test the integrity of the Achilles tendon Positive tests results in no movement in the foot Homan’s test Test for deep vein thrombophlebitis With knee extended and foot off table, ankle is moved into dorsiflexion Pain in calf is a positive sign and should be referred ;Compression Test;Ankle Stability Tests Anterior drawer test Used to determine damage to anterior talofibular ligament primarily and other lateral ligament secondarily A positive test occurs when foot slides forward and/or makes a clunking sound as it reaches the end point Talar tilt test Performed to determine extent of inversion or eversion injuries With foot at 90 degrees calcaneus is inverted and excessive motion indicates injury to calcaneofibular ligament and possibly the anterior and posterior talofibular ligaments If the calcaneus is everted, the deltoid ligament is tested;Anterior Drawer Test;Kleiger’s test Used primarily to determine extent of damage to the deltoid ligament and may be used t