Details of tibiofibular joint and ankle joint

2. Presentation of ankle joint And
tibiofibular joint
Presented by. Assigned by.
• Dr Alina Gafoor Dr Nimra Azhar
• Dr Nimra Imran
• Dr Ayesha Jawed
• Dr Misbah Ramzan DPT semester 2
• Batch 4th

3. Ankle joint
• Topic
• Represented by Nimra Imran. Represented by Misbah Ramzan
1. Articulation
2. Articulating surfaces Joint capsule
3. Ligaments Menisci
• Represented by Aysha Jawed Bursa
• Movements Clinical anatomy

4. Articulation
• Definition Of Articulation
• A joint or juncture Between bones and cartilages in a skeleton
of a vertebrate
• A moveable joint between rigid part of an animals
• The action or manner of jointing Or interrelating the
articulation of the limbs
• The state of being jointed and interrelated

5. • The ankle joint also know as the talocrural Joint, is a
synovial joint that connects the bones of the leg,the
fibula ,tibia with the talus of the foot
• It is a complex hinge joint composed of two
articulation

7. Joints including in ankle joint
• Ankle joint includes three types of joint
1. The ankle joint proper or talocrural Joint
2. Subtalar joint
3. Inferior tibiofibular joint

8. Movement at joint
• The movement produced at this joint is
dorsiflexion and plantar flexion of the foot
• In common usage, the term ankle refers
exclusively to the ankle region

10. Articular surface
• Definition
• surface at which the ends of bones meet is called articular
surface
• Joint can be classified on the bases of articular surface
1. Simple joint
• when two articular surfaces meet
• e.g shoulder joint

11. Composition of articular surface
• Articular surface are formed by Specialized haline
cartilage Which provides
• Wear resistance
• Low friction lubricated surface
• Elasticity
• Sheer during Weight bearing and muscle action

13. Articular surface of ankle joint
• Ankle joint is complex in articulation between
the distal end of tibia and the middle
melleolus and the lateral melleolus of fibula
and the troclear surface of talus
• All of the articular surfaces of the ankle joint
is cover with the haline cartilage

15. Subtalar joint
Subtalar joint is made up of
articulation between three joint
surface
InferiorLy talus with three joint
surface superiorly calcaneus
Subtalar joint Function as a
bridge between foot and ankle

16. Ligaments
• There are three ligaments in ankle joint
1. Fibrous capsule
2. Deltoid or medial ligament
3. Lateral ligament

17. Fibrous capsule
• Fibrous capsule are composed of thick fibrous connective
tissue, which form a protective sleeve around the joint
• The capsule is attached to bones forming the synovial joint
at specific zone
• The fibrous capsule is found in different thickness,
depending up on the amount of stress to which it exposed

19. Fibrous capsule of ankle joint
The joint capsule, anteriorly is broad, thin and fibrous
layer
• Posteriorly the fibers are thin,and run mainly
transversLy blending with the transverse ligament
• Laterally the capsule is thinkesed and attaches to the
hollow on the medial Surface of the lateral melleolus

21. Medial or deltoid ligament
• The midIal ligament is
very strong band of
tissue that wraps around
the inside of your ankle
and attaches with bones
of your foot

22. Lateral ligament
• The lateral collateral ligament of ankle joint
are ligaments of ankle joint that attached with
fibula
• Three ligaments of lateral collateral ligament
which composed It depicted

26. Movement of ankle joint
• There are two movements done by ankle joint
1. Dorsiflexion
2. Plantarflexion

28. Dorsiflexion
• Fore foot Raised
• Angle between front of leg and dorsum of foot diminished
• It’s a Closed Packets Position with max congruence or joint
• Wider Anterior troclear surface of the talus fits into lower
end of narrow posterior part of lower end of tibia
• So there is no chance in dislocation of dorsiflexion

30. Plantar flexion
• Fore foot depresed
• Angke between leg and foot is raised
• Narrow Posterior part of troclear surface of talus
losely fits into Wider anterior part of lower end of
tibia
• Can be dislocated by high heels

31. Muscle producing movement
• Dorsiflexion
• primary muscle
1. TA
• Accesory muscle
1. EDL
2. EHL
3. PT
• Plantar flexion
• Primary muscle
1. . Soleus
2. Gasterocnemius
• Accessory muscle
1. Plantaris
2. . TP
3. FHL
4. FDL

34. Blood supply of ankle joint
• The main blood
supply of The joint
Comes from the
anterior tibial artery,
posterior tibial artery
ant peroneal Artery

35. Nerve supply of ankle joint
• The ankle joint is
supplied by the tibial
saral, deep
peroneal,Suphenues
nerves, and accessory
deep peroneal nerve
when present

36. Bursa of ankle joint
• Bursitis is an inflammation of small fluid-filled sac
is called busra that help to reduced friction
between tandons and between tandon and bones
• Tha major bursa present in ankle region are
1. Achilles bursa or retrocalcaneal bursa
2. Bursa of middle malleolus

37. Achilles or retrocalcaneal bursa
• A bursa is a fluid- fill sac that cushions and
lubricates bones when they move.
• This bursa is located At back of your foot between
heel bone and Achilles tendon
• This bursa cushions and lubricates ankle joint it’s
called retrocalcaneal bursa

39. Bursa of middle malleolus
• Medial malleolar bursitis is caused by
inflammation or swelling in the bursa of middle
malleolus of ankle
• This bursa is located between the skin and medial
malleolus
• The flattened end of the tibia that forms the
prominance of the ankle,sometimes refers as the
ankle bone

41. Clinical anatomy of Ankle joint
• Ankle sprain
• Excessive stretching or tearing of ligaments
of ankle joint is called ankle sprain
• Cause –full from weight/ twists of ankle
• Inversion sprain os more common than eversion
Sprain

42. Condition
• Inversion
• Foot is plantar flexed-If it
excessively inverted
1. All bands of lateral
ligament is streched and
torn
2. Anterior tibiofibular
ligament is most commonly
damaging part
• Eversion
• Plantar flexed foot- if
excessively enverted
• Alusion fracture of melleolus
occur because deltoid ligament
is strongest ligament it will not
streched or torned easily

44. Dislocation of ankle joint
• Dislocation of ankle joint is rare
• Because it is very stable joint of tibiofibular
mortice
• Dislocation >> always with fracture of one
melleolus

45. Pott’s fracture
• If there is fracture with dislocation of ankle joint is Pott’s fracture
• Conditions or degree
• Pott’s fracture occur at three degrees
1. Primary /1°
2. Secondary/2°
3. Tertiary/3°

47. • Primary fracture
• Oblique fracture of lateral melleolus due to internal
rotation of tibia
• Secondary fracture
• Transverse fracture of melleolus of medial malleolus
due to pull by stronge deltoid ligament
• Tertiary fracture
• Fracture of lower end of tibia at posterior margin
• Know as trimalleolus fracture