Arches of Foot.pptx

1. ARCHES OF FOOT
DR. SUNDIP CHARMODE
ASSISTANT PROFESSOR

2. OBJECTIVES
1. Classification of arches
2. Composition of various arches
3. Functions of arches
4. Clinical correlation of arches of foot

3. INTRODUCTION
• Basic functions of foot.
• Skeleton of foot is arched – Longitudinally and
Transversely with concavity downwards

4. TYPES OF ARCHES
• Longitudinal :
1. Medial
2. Lateral
• Transverse :
1. Anterior
2. Posterior

6. MEDIAL LONGITUDINAL ARCH
• Summit is at a higher level, more mobile,
more resilient. Shock absorber
• Contributing bones are more –
1. Calcaneus
2. Talus
3. Navicular
4. Three Cuneiforms and
5. Medial Three Metatarsal bones upto their
heads and two sesamoid bones.

8. MEDIAL LONGITUDINAL ARCH
• Summit – Trochlear / upper surface of body of
Talus.
• Posterior End – Medial tubercle of calcaneus
• Anterior End - Heads of three metatarsal
bones
• Most vulnerable part – Head of Talus

9. MEDIAL LONGITUDINAL ARCH
• Anterior Pillar – long and weak
– Talus, Navicular, three cuneiforms and
– First three metatarsals.
• Posterior pillar – short and strong
– Medial part of calcaneum.
• Main Joint – Talo- calcaneo- navicular joint

10. FACTORS MAINTAING MEDIAL
LONGITUDINAL ARCH
1. Shape of the bones – Wedge shaped bones
2. Inter-segmental ties – Plantar Calcaneo-
navicular (Spring ligament)

11. FACTORS MAINTAING MEDIAL
LONGITUDINAL ARCH
3. Factors acting as tie-beams –
• Plantar Aponeurosis
• Abductor Hallucis
• Medial part of FDB
• Tendon of FHL
• Medial part of FDL
• Flexor Hallucis brevis

12. FACTORS MAINTAING MEDIAL
LONGITUDINAL ARCH
4. Suspending the arch from above :
• Tibialis anterior
• Superficial fibres of Deltoid ligament exert
sling action.
• Tibialis Posterior and its insertions support the
archf rom below.

18. LATERAL LONGITUDINAL ARCH
• Summit is low, limited mobility.
• Transmit weight and thrust to ground.
• Contributing bones are less :
1. Calcaneus,
2. Cuboid and
3. Fourth and fifth metatarsal bones upto their
heads.

20. LATERAL LONGITUDINAL ARCH
• Summit – At the level of Sub-talar joint
• Posterior End – Lateral tubercle of calcaneus
• Anterior End - Heads of fourth and fifth
metatarsal bones
• Most vulnerable part – Calcaneo-cuboid joint.
• Key stone - Cuboid

21. LATERAL LONGITUDINAL ARCH
• Anterior Pillar – Long and weak
– Cuboid
– Heads of fourth and fifth metatarsal bones.
• Posterior Pillar – short and strong
– Lateral half of calcaneus
• Main joint – Calcaneo-cuboid joint

22. FACTORS MAINTAING LATERAL
LONGITUDINAL ARCH
1. Shape of the bones – Calcanean angle of
Cuboid
1. Inter-segmental ties – Long and short plantar
ligaments act as important binding agents.

25. FACTORS MAINTAING LATERAL
LONGITUDINAL ARCH
3. Factors acting as tie-beams –
• Plantar Aponeurosis
• Abductor Digiti Minimi
• Lateral part of FDB
• Lateral part of FDL
• Flexor Digiti Minimi Brevis

26. FACTORS MAINTAING MEDIAL
LONGITUDINAL ARCH
4. Suspending the arch from above :
• Peroneus Brevis
• Peroneus Tertius
• From below :
• Peroneus longus

29. ANTERIOR TRANSVERSE ARCH
• Formed by the Heads of all the five metatarsal
bones.
• It is complete arch as both the ends …...
• Medial end : Head of First Metatarsal
• Lateral end : Head of Fifth Metatarsal

31. POSTERIOR TRANSVERSE ARCH
• Formed by :
–Three cuneiforms
–Bases and shafts of metatarsals.
• It is incomplete arch as only lateral end comes
in contact with ground.

33. FACTORS MAINTAING TRANSVERSE
ARCH
• Shape of bones –
– Round shaped – Anterior arch
– Wedge shaped – Posterior arch
• Inter-segmental ties – Plantar surface of tarsals
and metatarsals are tied together by
– Deep Transverse Metatarsal ligaments
– Other intrinsic plantar ligaments
– Dorsal Interossei
– Oblique and Transverse heads of Adductor Hallucis

35. FACTORS MAINTAING TRANSVERSE
ARCH
• Acting as Tie-beams :
• Anterior arch –
– Adductor Hallucis
– Deep transverse metatarsal ligaments.
• Posterior arch –
– Flexor Hallucis Brevis
– Inter-tarsal and Tarso-metatarsal ligaments

36. FACTORS MAINTAING TRANSVERSE
ARCH
• Acting from above / Slings –
– Peroneus Longus
– Tibialis Posterior
• Acting from the sides –
–Peroneus Tertius and Brevis from lateral
side
–Tibialis Anterior from medial side

37. FUNCTIONS OF ARCHES OF FOOT
1. Help in proportional distribution of weight.
2. They act as a segmented lever / springs
which helps in propulsive mechanism of
soleus and gastrocnemius and allows long
and short flexor muscles to exert their
actions in the forepart of foot.
3. They act as shock absorber in stepping and
jumping.

38. FUNCTIONS OF ARCHES OF FOOT
4. Plantar concavity of the arches protects the
plantar vessels and nerves from compression.
5. Arched foot is dynamic and pliable. It acts
like a spring board.
6. Invertor and Evertor muscles of the foot
produce a shift of weight distribution.

39. WALKING CYCLE

40. DISTURBANCES OF GAIT
1. Ataxia gait
2. Hemiplegic gait
3. Scissors gait
4. Staggering gait
5. Waddling gait
6. Cerebellar gait
7. Propulsion gait
8. Limping gait

41. DEFORMITIES OF FOOT
1. Flat foot
2. Pes Cavus
3. Club foot
4. March foot
5. Hallus Valgus
6. Hammer Toe

42. PES PLANUS

43. PES CAVUS

44. TALIPES EQUINUS

45. TALIPES CALCANEUS

46. TALIPES CALCANEUS

47. CONGENITAL TALIPES EQUINO VARUS

48. HALLUX VALGUS

49. HAMMER TOE

50. THANK YOU