Ottawa Ankle Rules

An ankle x-ray series is only required if there is pain in the malleolar zone AND any of these findings:

• Bone tenderness at the posterior edge or tip of lateral malleolus, OR
• 
  
• Bone tenderness at the posterior edge or top of medial malleolus, OR
• 
  
• Inability to bear weight both immediately after injury and at the time of assessment.

fleck sign

Fleck sign: medial cuneiform 과 2nd MT sapace에서 찾아야 함.

             임상적 의의: Lisfranc ligament의 avulsion을 의미함

ref) http://ortho-teaching.feinberg.northwestern.edu/cases/foot/case1/case9diagnosis.html(fig) 

1st ray의 normal angle

o 1^st ray의 normal angle(Fig. 78-2)

n Intermetatarsal angle(제 1-2 중족골간각) ^㈜

l 정의 : 1^st와 2^nd metatarsals 사이의 angle < 9°

n Hallux valgus angle(제 1중족골-족지골간각) ^㈜

l 정의 : 1^st metatarsophalangeal joint의 valgus angle <15°

         

      (Fig.78-2) Hallux valgus complex

      IM angle의 증가, sesamoids의 lateral D/L, 1^st MP joint의 subluxation, HV angle의 증가 & G. toe의 pronation을 관찰할 수 있다. 

Supination and pronation of ankle

Supination (to Supinate)

Excessive use of the lateral side of the foot for support and/or ambulation. Typically presents with varus heel, raised medial arch and forefoot adduction.

reference)

1. http://www.docpods.com.au/supination

2. http://cascadedafo.com/cascade-dafo-institute/glossary/S

Pronation (to Pronate)

Excessive use of the medial side of the foot for support and/or ambulation. Typically presents with valgus heel, collapsed medial arch and forefoot abduction.

reference)

1.http://victorsrunningblog.com/tag/pronation/

2. http://cascadedafo.com/cascade-dafo-institute/glossary/P

reference)

http://www.thesmileisfree.com/front?page=4

abduction and Adduction of foot and ankle

Abduction: To move away from the midline of the body.

Adduction: To move towards the midline of the body.

reference) http://cascadedafo.com/cascade-dafo-institute/glossary

족관절을 지나가는 건의 기능 4가지 및 각각에 해당되는 건

• 족관절을 지나가는 건의 기능 4가지 및 각각에 해당되는 건
• Dorsiflexor-inversion: AT
• Dorsiflexor-eversion: EHL, EDL
• Plantarflexor-inversion: PT, FDL, FHL, achilles
• Pantarflexor- eversion: Peroneous longus and brevis

Hallux valgus의 원인으로 작용하는 해부학적 abnormality

①  1^st MP Joint의 incongruency

②  1^st metatarsal head와 proximal phalangeal articular surface의 과도한 valgus tilt  

③  1st metatarsomedial–cuneiform joint의 증가된 obliquity

④  비정상적으로 긴 1^st ray

⑤  Pronated flatfeet

⑥  PTT(posterior tibial tendon)의 비정상적인 insertion

Kager’s triangle

Kager’s triangle (Kager’s Fat Pad) is bordered: Anteriorly by Tibia, Inferiorly by dorsal cortex of calcaneaus body, and posteriorly by Achilles tendon.