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Lower leg pathology


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movements at talocrural joint
plantar flexion dorsiflexion
movements at subtalar joint
inversion eversion
inversion ankle sprain
involve lateral ligaments of ankle
eversion ankle sprain
involve medial ligaments of ankle
high ankle sprain
dorsiflexion injury; involves tibiofibular ligaments ATF & PTF long healing time
inversion sprain history
roll in w/ slight plantar flexion
lateral ankle ligaments
anterior talofibular (ATF), calcaneofibular (CF), posterior talofibular (PTF)
most commonly sprained ankle ligament
medial ankle ligament
deltoid ligament
grade 1 ankle sprain
only ATF involved
grade 2 ankle sprain
ATF & CF involved
grad3 # ankle sprain
ATF, CF & PTF involved
ankle sprain treatment
RICE, protection (horseshoe pad w/ ace wrap), wrap distally tight, work proximally & looser
chronically weakened tendons
can rupture
peroneal tendonitis
can avulse 5th met
Achilles’ tendon rupture MOI
forceful contraction or overstretch
Achilles’ tendon rupture observation
visible deformity “window shade effect”
Achilles’ tendon rupture s/s
can’t plantarflex, audible pop, severe pain
Achilles’ tendon rupture commonly injured
weekend warriors
Achilles’ tendon rupture common location
2-6 cm above attachment b/c most avascular area of tendon
ankle tendinits history
usually overuse
difference between tibial and fibular fractures
tibial fractures create long-term problems if mismanaged, fibular fractures have shorter immobilization
stress fractures MOI
repetitive loading, usually to tibia, onset gradual
medial tibial stress syndrome
shin splints
shin splints palpation
pt tenderness over larger area, tuning fork will keep vibrating
shin splints treatment
tape attachment or arch as necessary
tibialis posterior strengthening
inversion, toe curling
compartment syndromes
acute trauma or repetitive trauma/ overuse
compartment syndromes most likely location
anterior compartment or deep posterior compartment, but can occur in any
name the 4 lower leg compartments
lateral, anterior, superficial posterior, deep posterior
actions in superficial posterior compartment
plantar flexion, toe flexion
actions in deep posterior compartment
(medial) inversion, plantar flexion, toe flexion
actions in lateral compartment
actions in anterior compartment
dorsiflexion, extend toes
2 kinds of compartment syndrome
exertional compartment syndrome, acute compartmental syndrome
exertional compartment syndrome
goes away w/o activity, not a medical emergency
exertional compartment syndrome treatment
fasciotomy to increase space; pressure is measured w/ a needle
acute compartmental syndrome
medical emergency; swelling can’t get out of compartment & puts pressure on nerves & blood, results in necrosis
most common acute compartment syndrome
anterior which leads to a dropped foot
acute compartmental syndrome palpation
check pulses, skin temp, capillary refill
acute compartmental syndrome observation
skin looks tight & glossy

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