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‫د‬
‫عامې‬
‫غتیا‬‫و‬‫ر‬
‫ت‬‫ر‬‫ا‬‫ز‬‫و‬
‫د‬
‫یر‬‫ز‬‫و‬
‫محمد‬
‫اکبر‬
‫خان‬
‫رح‬
‫ن‬‫غتو‬‫و‬‫ر‬
‫د‬
‫ا‬
‫و‬
‫توپيډي‬‫ر‬
‫او‬
‫ي‬‫ژ‬‫ټراوماټولو‬
‫ټمنټ‬‫ر‬‫ډيپا‬
‫الرحیم‬ ‫الرحمن‬ ‫هللا‬ ‫بسم‬
‫ډاکټر‬
‫کلیم‬
‫هللا‬
‫دګ‬‫ر‬‫و‬
،
‫د‬
‫توپيډي‬‫ر‬‫ا‬
‫او‬
‫اوماټولوژي‬‫ر‬‫ټ‬
‫د‬
‫ي‬‫لومړ‬
‫کال‬
‫ټريني‬
۱۲
/
۱۲
/
۱۳۹۹
‫د‬
‫ې‬ ‫پښ‬
‫د‬
‫هډوکو‬
‫میخانیکي‬
‫اناټومي‬
MechanicalAnatomyOf The Bones Of The Foot
FOREWORD
Walking
• Daily
• Lifetime
Running
• Speed
• Length
FOREWORD
Sprinting
• Vertical
• Horizontal
Velocity and Power
• Cardiac Concussion
• Fractures
PODIATRIST / CHIROPODIST (FOOT DOCTOR)
• High school
• College
• Podiatry school 4 years
• 3 years residency in a hospital
• After the residency, they can get
advanced certifications in surgery on feet
and ankles.
PROFESSIONAL FOOTWARE
• Curtis Martin
• Athens, Greece, Haile Begrselassei, a top
Ethiopian runner.
FOOT
FOOT ARCHES
BRIDGE ENGINEERING
TALUS
Three parts:
the body
the head,
the neck
TALUS REPLACEMENT
CALCANEUS
The calcaneus is commonly known as the heel
bone. The calcaneus is the largest bone in the
foot, and along with the talus, it makes up the
area of the foot known as the hind-foot. There
are three protrusions (anterior, middle, and
posterior facet) on the superior surface of the
calcaneus that allow the talus to sit on top of
the calcaneus, forming the subtalar joint (The
calcaneus also connects to the cuboid bone to
form the calcaneal-cuboid joint.
CUBOID
The cuboid bone is a square-shaped bone on
the lateral aspect of the foot. The main joint
formed with the cuboid is the
calcaneocuboid joint, where the distal aspect
of the calcaneus articulates with the cuboid.
NAVICULAR
The navicular is distal to the talus and
connects with it through the talonavicular
joint. The distal aspect connects to each of
the three cuneiform bones. Like the talus,
the navicular has a poor blood supply. On its
medial side (closest to the middle of the
foot) the navicular tuberosity is the main
attachment of the posterior tibial tendon.
CUNEIFORMS
There are three cuneiform bones in the foot:
the medial, medial (intermediate), and
lateral cuneiforms These bones, along with
the strong plantar and dorsal ligaments that
connect to them, provide a good deal of
stability for the foot.
PHALANGES
The first toe, also known as the great toe or
hallux, is the only one to have two phalanges;
the other lesser toes have three. These are
known as the proximal phalanx (closest to the
ankle) and the distal phalanx (farthest from the
ankle). The phalanges form interphalangeal
joints between themselves: a proximal
interphalaneal joint (PIP) and the distal
interphalangeal joint (DIP) .
METATARSALS
Each foot contains five metatarsals, numbered 1-5 medial
(great toe) to lateral. The first three metatarsals medially
are more rigidly held in place than the lateral two. The
metatarsals articulate with the mid-foot at their base, a
joint called the tarsal-metatarsal (TMT) joint, or Lisfranc
joint. The TMT joint is made stable not only by strong
ligaments connecting these bones, but also because the
second metatarsal is recessed into the middle cuneiform
in comparison to the others .The metatarsal heads are
the main weight bearing surface and the site where the
phalanges attached at the metatarsal-phalangeal (MTP)
joint.
‫التوفیق‬ ‫هللا‬ ‫من‬ ‫و‬
Reference:
• https://www.wsj.com/articles/SB874963554415123500
• https://phys.org/news/2017-01-strong-egg.html
• https://pubmed.ncbi.nlm.nih.gov/9314393/
• https://en.wikipedia.org/wiki/Haile_Gebrselassie
19
‫مننه‬

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(Orthopedics) The mechanics of the bones of the feet (with notes in English and Pashto) By Dr. Kalimullah Wardak

Editor's Notes

  1.  Usain bolt 45km/hour Dean Karnazes, a world-famous endurance runner, who ran 350 miles in 2005 Thankfully, Karnazes didn't die during his 80 hour, 44 minute Ran 350 miles (560 km) in 80 hours and 44 minutes without sleep in 2005 jumptownutah.com Javier Sotomayor of Cuba men’s high jump in 1993 8 feet high. He could jump right onto the roof   In 1991 American Mike Powell long jump by jumping 8.95 meters, that is 29 feet 4 inches wouldn’t need to use the crosswalk
  2.   jumptownutah.com Javier Sotomayor of Cuba men’s high jump in 1993 8 feet high. He could jump right onto the roof   In 1991 American Mike Powell long jump by jumping 8.95 meters, that is 29 feet 4 inches wouldn’t need to use the crosswalk  Cardiac concussion (commotio cordis) Blunt chest trauma in pediatric patients can result in various injuries to the myocardium. Cardiac concussion (commotio cordis) is seen in patients in whom the precordium has been struck with relatively little force at a vulnerable period of the cardiac cycle. These patients have no predisposing cardiac problems, and autopsy reveals no evidence of heart damage. The usual clinical presentation is that of immediate collapse secondary to a lethal arrhythmia. Prevention is the cornerstone of potentially decreasing the incidence with the aid of safety equipment and, possibly, immediate defibrillation. The fastest football kick is 129 km/h (80.1 mph) achieved by Francisco Javier Galan Màrin (Spain) at the studios of El Show de los Récords, Madrid, Spain on 29 October 2001. Guinness box 80km/hour 1300 pounds
  3.  Cardiac concussion (commotio cordis) Blunt chest trauma in pediatric patients can result in various injuries to the myocardium. Cardiac concussion (commotio cordis) is seen in patients in whom the precordium has been struck with relatively little force at a vulnerable period of the cardiac cycle. These patients have no predisposing cardiac problems, and autopsy reveals no evidence of heart damage. The usual clinical presentation is that of immediate collapse secondary to a lethal arrhythmia. Prevention is the cornerstone of potentially decreasing the incidence with the aid of safety equipment and, possibly, immediate defibrillation. The fastest football kick is 129 km/h (80.1 mph) achieved by Francisco Javier Galan Màrin (Spain) at the studios of El Show de los Récords, Madrid, Spain on 29 October 2001. Guinness box 80km/hour 1300 pounds
  4. 4.71million dollars a year د امریکایی فوتبال اتل Curtis Martin 6million ۵۰۰۰ ډالره بوټ، انجینران.. ځيرک تریدمیل.. تری ډی سکن، بایوفوم قالب چپ لرونکې ځمکه.. لس چنده وزن لیزر.. امریکایی عسکرو خول 1 million 50million
  5. Chicken eggs were found to have a compressive strength of 100 lbs, whereas ostrich eggs gave values of more than 1000 lbs. https://phys.org/news/2017-01-strong-egg.html نیشنل جیوګرافیک میدیل، لېترل، ترانسورس طولاني قوسونه اجسادو باندې تجربه ځينی هوار پښې ولې درد نه لري؟ ځکه افقي قوس يې ښآيي لوړ او ځواکمن وي. وروسته لدې باید یوازي د انسي قوس سقوط و نه کتل شي، بلکې د افقي قوس انحناء هم په نظر کې ونيول شي. ښايي دا علت وي چې په ځينو کې ارتوپيديک مداخلات ښه نتيجه نه ورکوي. ښايي په اينده کې د دری بعدي سکن له مخې مناسب بوټونه هر کس ته ډيزاين شي. نو بايد ومنو چې پښه درۍ بعدي ده، او په همدې دول بايد چلند ورسره وکړو. ښې مصنوعي او روبوټيکې پښې جوړولای شو، ارتوپيدستان ښه امراض تداوي کولای شي.. او حتی مناسب بوټونه ډيزاين کولای شو.
  6. Chicken eggs were found to have a compressive strength of 100 lbs, whereas ostrich eggs gave values of more than 1000 lbs. https://phys.org/news/2017-01-strong-egg.html نیشنل جیوګرافیک میدیل، لېترل، ترانسورس طولاني قوسونه اجسادو باندې تجربه ځينی هوار پښې ولې درد نه لري؟ ځکه افقي قوس يې ښآيي لوړ او ځواکمن وي. وروسته لدې باید یوازي د انسي قوس سقوط و نه کتل شي، بلکې د افقي قوس انحناء هم په نظر کې ونيول شي. ښايي دا علت وي چې په ځينو کې ارتوپيديک مداخلات ښه نتيجه نه ورکوي. ښايي په اينده کې د دری بعدي سکن له مخې مناسب بوټونه هر کس ته ډيزاين شي. نو بايد ومنو چې پښه درۍ بعدي ده، او په همدې دول بايد چلند ورسره وکړو. ښې مصنوعي او روبوټيکې پښې جوړولای شو، ارتوپيدستان ښه امراض تداوي کولای شي.. او حتی مناسب بوټونه ډيزاين کولای شو.
  7. The rounded head of the talus is the keystone in the center of the medial longitudinal arch The cuboid is the keystone in lateral long. Arch . The arches of the feet are maintained by the shape of the bones, strong ligaments, and muscle tone. Athletes, route-marching soldiers, and nurses are able to sustain their arches provided that they receive adequate training to develop their muscle tone.
  8. (Figure 5). The talar body, which is roughly square in shape and is topped by the dome, connects the talus to the lower leg at the ankle joint. The talar head is adjacent to the navicular bone to form the talonavicular joint. The talar neck is located between the body and head of the talus. The talar neck is one of the few areas of the talus not covered with cartilage, and is thus the point of entry for the blood vessels supplying the talus. The talus is the top (most proximal) bone of the foot. Because it articulates with so many other bones, 70% of the talus is covered with hyaline cartilage (joint cartilage). The talus connects to the calcaneus on the underside through the subtalar joint, and distally it connects to the navicular through the talonavicular joint. These articulations allow the foot to rotate smoothly around the talus. Owing primarily to the fact that no tendons attach to it and that most of its surface is cartilage, the talus has a relatively poor blood supply. The lack of a robust blood supply means that injuries to this bone take greater time to heal than might be the case with other bones—and some injuries will not heal at all.
  9. We inserted the talar body prosthesis in sixteen patients - twelve who had avascular necrosis of the talar body and four who had a severe crush fracture of the talar body - between 1974 and 1990. Three patients who were evaluated five years postoperatively had a satisfactory result, and one patient had failure of the prosthesis at eight months because the diameter of the inferior concave curved surface was too small in the region of the posterior facet and had caused erosion of the posterior facet of the calcaneus. All three patients who were evaluated six to ten years postoperatively had a satisfactory result. All except one of the nine patients who were evaluated eleven to fifteen years postoperatively had a satisfactory result; the exceptional patient had an unsatisfactory result because the prosthetic stem had sunk into the talar neck. This patient had a revision thirteen years after the index operation. We believe that the talar body prosthesis can be used to replace the body of a talus with avascular necrosis or a severe crush fracture, thus maintaining the function of the ankle and the foot for a prolonged period