Ankle joint: functions, structure, main diseases and treatment methods. Ankle ligaments: photos, types of injuries and treatment Complex ankle joint
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acting on this joint, their blood supply and innervation; X-ray image of the ankle joint.
Ankle(supratalar) joint,articuldtio talocruralis (Fig. 104, 105; see Fig. 103). This is a typical trochlear joint. It is formed by the articular surfaces of both bones of the tibia and the talus. On the tibia, this is the lower articular surface, articulating with the trochlea of the talus, and the articular surface of the medial malleolus, articulating with the medial malleolar surface of the trochlea of the talus. , On the fibula, it is the articular surface of the lateral malleolus, articulating with the lateral malleolar surface of the talus. United together, the tibia and fibula, like a fork, cover the block of the talus. The articular capsule has the shape of a short cuff, which is attached on the anterior surface of the leg bones and on the talus 5-8 mm anterior to the articular cartilage, and posteriorly and laterally along the line of the articular cartilage. On the sides of the joint the capsule is strong and thick, in front and behind it is thin and loose, forming folds.
Ligaments that strengthen the joint are located on the lateral surfaces of the joint. Medial (deltoid) ligament, llg. mediate (deltoideum) (see Fig. 104, 105), located on the medial surface of the joint, has the shape of a wide fibrous plate diverging downwards. This thick, strong ligament begins on the medial malleolus, goes down and attaches with its expanded end to the navicular, talus and calcaneus bones. It has four parts: the tibiofacial part, pars tibionavicularis; tibiocalcaneal
Part, pars tibiocalcanea; anterior and posterior tibial-talar pain, paries tibiotalares an terior et posterior;, On the lateral side of the joint, the capsule is strengthened by three ligaments. Anterior talofibular ligament, lig. talofibulare anterius, thin, short, rectangular in shape. It runs almost horizontally, attaches to the outer surface of the lateral malleolus and to the neck of the talus. Posterior peroneal ligament, lig. talofibulare pos- terius, located on the posterolateral surface of the joint.
It starts from the lateral malleolus, goes posteriorly and attaches to the posterior process of the talus. Calcaneofibular ligament, lig. calcaneofibulare, starts from the lateral malleolus, goes down and ends on the outer surface of the calcaneus.
In the ankle (supratalar) joint, movement around the frontal axis is possible - flexion (plantar flexion) and extension (dorsal flexion). The total range of movement is 60-70°. With plantar flexion, small movements to the sides are possible, since in this case the narrowest part of the talus block enters the widest part between the ankles, the bones of the lower leg.
Joints of the tarsal bones are represented by the following joints: subtalar, talocaleonavicular, calcaneal-cuboid, transverse tarsal joint, cuneiform, tarsometatarsal (Fig. 106).
talocaleonavicular joint,articulatio talocalcane -
onavtcularis . This joint includes two joints that have
independent capsules and separate articular cavities. Per-
the first of them is formed by the articulation of the posterior calcaneal articular
surface located on the lower surface of the talus
bones and the posterior talar articular surface, located -
on the upper surface of the calcaneus. Articular surfaces
The joint capsule is thin and loose. He
stands out as subtalar joint,articulatio subtalaris.
The second joint is formed by the articulation of the head of the talus with the navicular bone in front (talonavicular joint) and the calcaneus below, "In this case, the anterior talar articular surface of the calcaneus is complemented by the plantar calcaneonavicular ligament, lig. calcane- onaviculare plantare, which is a fibrous cord 0.5 cm thick. This ligament is stretched between the inferomedial edge of the talus support of the calcaneus and the lower surface of the scaphoid bone. It supports the head of the talus. In the place where the ligament comes into contact with the head of the talus, fibrocartilage is located in the thickness of the ligament. The articular capsule is attached along the edge of the articular surfaces, forming one articular cavity.
The talocaleonavicular joint is supported by ligaments. Interosseous talocalcaneal ligament, lig- talocalcaneum interosseum, located in the sinus of the tarsus and connects the surfaces of the grooves of the calcaneus and talus facing each other. This ligament is very strong, tight / pulled between articulating bones.
Taraino-navicular ligament, lig. talonavicu- Idre, strengthens the joint from above and connects the dorsum of the neck of the talus and the scaphoid.
Based on the shape of the articular surfaces, the talocalcaneal-navicular joint can be classified as spherical, but movement in it is possible only around the sagittal axis, which passes through the medial part of the head of the talus and emerges from the lateral surface of the calcaneus. Movement is in this joint is carried out simultaneously in both of its parts, i.e. both joints function together as a combined joint C. The range of movement in these joints is limited due to the mismatch of the centers of their axes of movement, the small difference in the area of the articular surfaces and the presence of tightly stretched ligaments. In such a combined joint, it is carried out around the sagittal axis - adduction and abduction, the talus remains motionless, and together with the calcaneal and navicular bones the entire foot moves. During adduction (outward rotation), the medial edge of the foot is raised, and its dorsal surface turns lateral side (supination). During abduction (inward rotation), the lateral edge of the foot rises, and its dorsal surface turns to the medial side (pronation). The total range of movements around the sagittal axis does not exceed 55°.
In a child (especially the first year of life), the foot is in a supinated position, so when walking the child stands the foot is not on the sole, but on its lateral edge. With age, the foot pronates (lowering of its medial edge).
The ankle joint is the most sensitive and important mechanism in the anatomy and structure of the foot, which consists of bone, muscle and tendon formations; when they work together, it is possible to move the foot, maintain balance and stability in an upright position.
The ankle joint regulates the range of motion that the foot performs, softening impulses during movements, walking and jumping.
Moreover, this part of the foot is most sensitive to various injuries and infectious and inflammatory processes.
Why this happens will become clear when we consider the structure of the human ankle joint.
Anatomical features of the ankle
The uniform distribution of a person's weight on the foot occurs due to the ankle joint. The anatomical upper limit is conventionally located seven to eight centimeters above the medial malleolus.
The boundary between the joint and the foot is the line between the ankles. The lateral is located on the other side of the medial.
The joint has internal, external, anterior and posterior sections. The front is the back. The posterior section is located in the area of the Achilles tendon.
The inner section is located in the area of the medial malleolus, the outer section in the area of the lateral ankle.
Detailed structure
Bones
The ankle joint combines the fibula and tibia with the supracalcaneal bone - the talus and the foot bone.
The regrown part of the bone fits into the hole between the lower bones of the fibula and tibia, and the ankle joint is formed near this joint.
It is customary to highlight:
- - internal malleolus - is the lower edge of the tibia;
- - the outer malleolus is the edge of the fibula;
- - lower area of the tibia.
At the back of the outer part of the ankle there are depressions in which the tendons that connect to the peroneal muscles are fixed. Shells of connective tissue (fascia) together with the lateral articular ligaments are fixed to the outside of the ankle.
The ankle joint has a gap that forms on the inner surface of the upper side of the talus and hyaline cartilage.
Bottom surface of border
The tibia is similar in appearance to an arch. There is a process on the inside of the arch. On the tibia there are processes called the anterior and posterior malleolus.
fibular notch
Located on the outer side of the tibia. On the side of this notch there are tubercles. Part of the lateral malleolus is located in the fibular notch, which together with the lateral malleolus form the tibiofibular syndesmosis.
In order for the joint to function effectively, it is necessary to monitor its condition. The back is larger than the front.
Bone ridge
Divides the surface of the joint into internal and external.
The inner malleolus is formed from the anterior and posterior tubercle of the articular surface. Separated from each other by a hole. The posterior tubercle is smaller than the anterior one.
Heel bone and shin bone
They are united by the talus bone. Thanks to the block, it connects to the lower leg. Between the distal parts of the fibula and tibia, a so-called “fork” is formed; the block of the talus is located in it.
On the upper side, the block has a convex shape with a recess into which the crest of the distal epiphysis of the tibia enters.
The anterior block is slightly larger, part is located in the neck and head. On the back there is a small protrusion with a groove, along which the bend of the thumb passes.
Muscles
The muscles are located on the back and outside, distinguished:
- - posterior tibial;
- - triceps surae muscle;
- - long flexor muscle of the toes;
- - plantar.
In the anterior section there are extensor muscles:
- - long extensor of the big toe;
- - anterior tibial;
- - long extensor of the other toes.
Pronators also provide inward and outward movement in the joint.
Ligaments
The proper functioning of the joint is carried out thanks to ligaments, which fix the bone elements in place.
The deltoid ligament is considered the most powerful, it helps connect the talus, navicular and calcaneus bones on the inside of the ankle.
The ligaments of the external part include: the calcaneofibular ligament, the posterior and anterior talofibular ligaments.
Interfibular syndesmosis is a formation that is a ligamentous apparatus. To prevent excessive inward rotation, there is a posterior inferior ligament; it acts as a continuation of the interosseous ligament. And the anterior lower tibiofibular ligament, which is located between the peroneal notch, prevents sudden external rotation.
Blood supply
The blood supply to the joint passes through three blood arteries - the anterior and posterior tibial and peroneal.
Venous outflow is represented by a wide network of vessels, divided into external and internal networks. They then form the small and large saphenous veins, the anterior and posterior tibial veins. Connected to each other by a network of anastomoses.
Lymphatic vessels have the same course as blood vessels, the outflow of lymph passes in front and parallel inside the tibial artery, and outside and behind - the peroneal artery.
The branches of the nerve endings, as well as the superficial peroneal, tibial, sural and deep tibial nerves are located in the ankle joint.
Basic functions of the ankle
- — ensuring body mobility;
- — uniform distribution of a person’s weight over the entire foot;
- — shock absorption of sudden movements;
- - reduces shaking that occurs while walking or running;
- - provides body stability;
- — gives smooth movements when walking on steps;
- — provides stability to the body when moving on uneven surfaces.
The foot has an important function in the human skeleton. Nature allowed man to walk upright, and during evolution, the feet acquired the ability to reliably and steadily bear the weight of the body. However, in life a person is quite mobile and maneuverable, and these opportunities are provided by the structure of the ankle. It can withstand constant static load and allows a person to move at the required rhythm.
The ankle is a skeletal support that allows a person to use his legs to walk, run, squat, jump, dance, play sports, and do his work. The foot is able to bear the load of weight, which is reflected in its structure. To understand the causes of pathologies of this organ, every person needs to know the structure of the ankle joint.
The ankle is a group of bones from the knee to the foot, with connecting joints. It is this part of the limb that bears the weight of a person.
There is no main element in the structure of the lower leg - they work perfectly and perform their functions only in common connection. The ICD code for the anatomy of the ankle joint corresponds to 10, by which you can find the names and descriptions of the necessary elements of the articular joint.
Due to its high functionality, the ankle group is the most vulnerable; sometimes even a small bruise leads to a person losing the ability to move. Connecting the foot to the lower leg, the bones must be healthy and strong in order to fully carry out all the necessary functions. The anatomy of the ankle joint is quite complex. Nature decided to reward the leg with several bones, closely connected by cartilage, muscles and ligaments.
The structure of the ankle joint plays an important clinical role in human mobility. These parts of the legs are at high risk of disease and injury during active human movements. Having created the shin thin and strong, nature warns a person: take care of your legs from excessive loads and possible damage, because only during one active day a person can walk tens of kilometers, while loading the ankle joints. And this can cause unexpected, complex pain in the legs.
Features of the anatomy of the ankle joint
Anatomy of the ankle joint
It is the ankle apparatus that is responsible for distributing human weight over the entire surface of the foot. The weight load is different for each person, and the anatomical structure of the joint and bones is almost the same for everyone, except that women have thinner ankles and slimmer calves. From above, the anatomical boundaries are 7-8 cm above the medial malleolus. The visual line between is the main boundary between the foot and the joint. The lateral and medial malleolus are opposite each other, on either side of the bone.
The lateral malleolus of the fibula – in Latin “malleolus lateralis fibulae” – is the lateral one, lying further from the middle. The concept “medial” in Latin means the antonym of the concept “lateral”. The medial malleolus of the tibia is called “malleolus medialis tibiae” in Latin and is located closer to the middle. The medial malleolus is called the internal one, and the lateral one is called the external one.
The next point is a group of joints that have sections on the inner, outer, front and back sides of the leg. The forefoot is the dorsum of the foot. The elastic Achilles tendon region is the posterior region that includes the sole of the foot.
The bone and articular structure of the ankle includes the fibula, tibia, and supraheel bones. The supracalcaneal bone has several other names - the talus or simply the bone of the foot. It has an accessory process that physiologically fills the space between the lower distal ends of the fibula and tibia. These bones, ligaments, joints, vessels, cartilage and their connective soft tissues form the ankle joint. The sesamoid bone is also located here, which is hidden in the thickness of the tendons that spread over the joints.
This is the ankle joint, which includes:
- internal ankle - the lower, distal part of the tibia;
- external ankle - the lower part of the fibula;
- bony surface of the distal tibial articulation.
The tendons that support the long and short peroneus muscles are fixed in the recesses of the lateral ankle. The ends of the bones are covered with fascia, a sheath of connective tissue that is attached to the outside of the ankle along with the lateral ligaments. According to their physiological purpose, fascia is a kind of protective sheath that covers tendons, blood vessels, and nerve fibers. The peculiarity of the attachment of the fascia and deltoid ligament is that there are no articular surfaces in their connection.
There is a large notch on the tibia, into which the base of the fibular notch enters - this is the tibiofibular syndesmosis, the health of which is very important for the full functioning of the general articular joint. This syndesmosis must be permanent to ensure full performance of the functions of the leg.
The ankle joint has a gap formed from the inside adjacent to the hyaline cartilage. On the right and left legs they look symmetrical, as if in a mirror image. The structure of the ankle joint is block-shaped, in the form of a helical joint. In essence, this is a hinge joint that provides possible movements of the foot in different planes.
The structure of the muscles of the ankle joint
The structure of the ankle joint cannot be imagined without a muscle group. The articular muscles pass behind and outside the ankle, so as to ensure flexion of the foot, rotation of the leg up and to the left - as its owner wishes.
Muscles working for flexion:
- long flexor muscles that allow flexion of the toes;
- tibial posterior;
- dense and massive plantaris muscle;
- triceps surae muscle.
Muscles working for extension:
- tibial anterior;
- extensor muscles that provide extension of the toes.
In their complex, the muscle group on each leg provides the necessary movements of the foot so that a person moves steadily and confidently and maintains balance through the work of the ankle muscles. This is the norm for healthy ankles.
In addition, the structure of the ankle includes ligaments. Their task is to ensure normal functions and movements of joints, supporting bone elements in their places. The most powerful ligament in the structure of the ankle is the deltoid. It connects the talus, calcaneus and the inner malleolus. It can only be torn in an extreme situation with extremely increased loads, and this will be a very serious injury with pronounced signs.
The articular joint is nourished by a network of blood vessels. The arteries pass here: peroneal, anterior, posterior tibial. At the site of the articular capsule, the arteries branch, forming a vascular network. The outflow of blood is carried out through networks on the outer and inner sides of the bones; the networks smoothly connect into the anterior and posterior veins on the tibia, into the small and large veins located deep under the skin.
Thin veins are connected into large venous vessels of a single network by anastomoses - anastomōsis venosa, they are a natural formation that leads to a tight connection of venous vessels, and are among the important elements of the structure of the ankle.
Functions of the ankle joint
Anatomy of the bone structure of the ankle joint
In the skeletal structure, in which students study the anatomy of the human bone structure, the bones of the ankle move easily around their axis, along the axial axis, which has its base at a point in the center of the outer malleolus. However, its own axis is in a strictly geometric relationship to the center of the internal axis. In fact, connected by articular tendons and bone muscles, a person’s feet can move at an angle from 60 to 90 degrees.
An important function of the ankle joint is dorsiflexion and plantar flexion of the feet. Constancy in movements is maintained thanks to the fibula, and the main work is performed by the collateral ligaments, which include the deltoid. A bent foot is the result of the coordinated work of all the components of the ankle. In addition to motor function, support function is also of great importance.
Nature created the structure of the ankle for walking and human movements. The coordinated work of the articular muscles ensures rotation in two planes - frontal and vertical. The soft tissues of this part of the human skeleton provide shock absorption, preserving the integrity of the bone structures. However, due to the high mobility and weight of the body, injuries and injuries of varying degrees of complexity often occur in this area. The possibility of deforming a joint is extremely high.
The protrusion of the heel tuber makes it difficult to wear dress shoes; the foot hurts and swells when walking for a long time. This is not just a violation of the anatomy of the ankle structure, but a good reason to understand its condition. Therefore, the ankle needs strengthening, special exercises must be performed.
Possible pathologies of the ankle group
Arthrosis of the ankle joint
Ankle diseases are associated with various reasons, these are:
- all kinds of injuries, including sports;
- inflammatory processes;
- arthrosis;
- bursitis;
- tendinosis;
- infectious diseases;
- spine pathologies;
- pathologies of the foot structure.
With any pathology, a person experiences pain of varying strength throughout the entire foot, ankle, and heel. Swelling occurs in the area of the outer and inner ankles, with skin hyperemia. With such symptoms, the flexion and extension of the foot is limited, or the foot rolls outward. It is not difficult to identify inflammatory diseases in the ankle area; it is more difficult to cure them so thoroughly that they do not develop into chronic arthritis or osteoarthritis.
They occur against the background of injury, infection in open wounds, due to inflammation of the respiratory system, due to autoimmune processes. Reactive arthritis also happens - as a concomitant disease in the treatment of other inflammatory diseases. Developing reactive arthritis accompanies gout, rheumatism, severe forms of ARVI, and influenza.
They may not hurt much, but annoying nagging pains will soon bring even a patient person to the hospital to see a doctor. And this is correct, since the doctor monitors how the injured leg heals, for which control X-rays are taken.
In more complex injuries, an implant is used that is implanted at the site of damage to the joints, and the healing of such an injury, of course, requires the supervision of a doctor. If the nerve is damaged, this is not visible on x-rays in different projections.
However, a person feels a dumb part of the ankle, and consultations with a neurologist or neurosurgeon are included in the inpatient treatment plan. Their help will also be required in the case of trabecular edema, a pathologically complex change in both the structure and topography of the bone. This type of swelling can only be removed through surgery.
Types of Ankle Injuries
List of the most common injuries:
- sprain; the person experiences severe pain, unsteadiness of gait, loss of balance;
- ligament rupture; severe swelling, severe pain, and limitation of movements appear;
- subluxation or dislocation of the joint;
- bruises;
- falls, blows that lead to broken bones.
If your ankle is injured, you should call an ambulance. Before the doctors arrive, you can - if you have the skills - apply an aseptic bandage and fix the leg in a stationary position. The complex anatomical structure of the ankle joint is the basis for the most severe injuries, the appearance of which can only be shown on MRI, not even on X-rays.
With a traumatic injury to the ankle, nerve endings and muscles are damaged, ankle bones are broken, ligaments and muscle fibers are torn, and bone fractures and cracks occur. There is only one way out - to lie down and be treated under the supervision of surgeons. After all, even a small muscle tear can cause tissue necrosis in the area of injury.
There is a separate diagnosis - hygroma. This benign tumor is a capsule filled with a colorless viscous liquid. It is usually localized in the joint capsule and is treated either by surgical removal or conservative medications. This depends on the stage of the disease and the growth rate of the tumor.
Before surgery, the surgeon draws up a drawing of the tumor, a diagram of its attachment points to the internal tissues, possible places for its cutting, and final stitching lines. This allows the operation to be performed in the least traumatic way. The tumor protrudes at the site of localization, does not redden, does not hurt much, the person is more concerned about itching than pain and swelling. This formation is not at all dangerous to human life, it just looks unsightly, which worries mainly women.
Any ankle injuries should be treated only with the help of specialists, otherwise the person may be left without the ability to walk normally. Traditional methods of treatment at home are good when traditional treatment with medications is already in full force, perhaps after a successful surgical operation. Then traditional medicine, perhaps yoga, and exercise therapy will become good helpers in getting rid of pain and enhancing the effectiveness of medications.
Traditionally, a plaster cast is applied to the injured leg, or modern plastic bandages and orthoses are used, which depends on the complexity of the injury and the decision made by the treating surgeon. And for a whole year after the injury you will have to wear an elastic bandage, because it greatly facilitates the process of walking and bending. The traumatologist prescribes various ointments to reduce pain and stabilize the condition of the joints.
Hygroma in the ankle area
The difference in ointments is insignificant - any composition of components is aimed at reducing pain, swelling, and relieving the inflammatory process. Among traditional medicines, doctors recommend apple cider vinegar for local lotions.
If there is severe pain in the ankle joint and limited movement, a person needs a doctor. It is not recommended to start treatment at home. A surgeon, traumatologist, therapist - any specialist who will conduct an initial examination and prescribe the necessary examination will help. Any ankle injury can be treated so that the joint retains its natural shape. Old arthritis can become inflamed due to a simple injury, for example, if a sprain occurs. However, in many cases, chronic complications remain, and joint pain accompanies a person throughout his life.
There is a person who lends a helping hand to all people with painful joints - this is Doctor of Medical Sciences, Professor Sergei Mikhailovich Bubnovsky. He names more than 20 universal methods for treating various forms of injuries and diseases of the joints, and assures that diseased joints can be cured even in old age. According to reviews from his patients and readers of his medical publications, Bubnovsky’s technique really works with a bang.
Both adults and children who have suffered ankle injuries can confidently get back on their feet. Why can Dr. Bubnovsky put anyone on their feet, even from a wheelchair? Because his method has been working for more than 30 years. His technique is favored by many patients and his colleagues.
As a result of evolution, man began to walk upright, and the musculoskeletal and musculoskeletal systems underwent serious changes. is a support for the entire human skeleton. It is able to withstand incredible loads, while providing full movement of both feet.
Due to its purpose, the foot regularly experiences pressure exerted by the entire weight of a person. The ligaments of the ankle joint play an important role in ease of movement. The anatomical features of the structure of the foot, which directly affect the strength of the lower leg, did not go unnoticed.
The structure of the ankle allows a person to move with a maximum amplitude of 60-90 0 . We can safely call this ankle joint the most maneuverable. The capabilities of the foot are no less amazing.
Its structure allows you to perform the following manipulations:
- Circular rotations.
- Deviations in different directions (inward, outward, upward).
- Flexion and extension.
But despite all the advantages, the ankle joint of the leg is very susceptible
Unpleasant deformities:
- Fractures.
- Injuries of the ligamentous apparatus.
- Cracks.
These problems allow us to judge the absolute insecurity of this area.
Joint structure
Due to the labor-intensive work of the ankle, its structure is quite complex.
There is an interconnection of such structures as:
- bone;
- ligamentous;
- muscular;
- blood supply structure;
- nervous system.
The ankle joint of the leg is visually divided into sections. The top of the foot is the forefoot that has the greatest mobility. It starts above the ankle line less than 8 cm.
The back of the ankle is the area of the Achilles tendon. This area can without a doubt be called the most massive and strong part of the joint. In the area of the lateral part of the ankle there is an outer section, and the area of the medial ankle serves as the border of the inner section of the ankle. The middle section (the combination of the previous two) provides stability to the foot.
External department
Its task is to provide mobility to the toes.
For this purpose, nature has provided the following joints:
- Metatarsophalangeal. Type of ball and socket joints.
- Interphalangeal. Type of block connections.
The lateral ankle ligaments strengthen the capsules of each joint, providing stability.
Middle section
The internal (middle) section is equipped with two connections:
- Less mobile calcaneocuboid.
- More mobile is the talocalcaneal-navicular.
Their combination gives rise to the intertarsal joint.
Posterior
It is formed by two important bones: the talus and the calcaneus. The latter performs a shock-absorbing function.
Articular bones
The anatomical structure of the area in question is based on the well-known bones of the lower leg:- Big tibia.
- Small tibia.
Both frame the trochlear prominence of the talus, connecting directly to the human foot.
The structure of the lower extremities is divided into:
It is the talus tarsal bone that connects to the ankle.
The lateral sides of the ankle are distinguished by the presence of a lateral and medial malleolus. Their anatomical dissimilarity (one is shorter and wider) ensures the mobility of this area.
The tendons of the muscles of the thin tubular bone of the leg are attached to the posterior edge. The outer surface connects the lateral ligaments with the fascia (connective tissue membranes). The inner covering of the ankle is hyaline cartilage. Together with the talus, it creates the ankle gap, which ensures its stability. And the special arrangement of bones in the foot forms the transverse and longitudinal arches.
The bones that form a joint are held together by a set of ligaments. They monitor the stability of the joint.
All components of the ankle are connected to each other by tendons. Nutrition of tissues is provided by the circulatory system. And sensitivity is nerve endings.
Joint ligaments
The ligamentous system is divided into three important groups:
First group
Fixes the bones of the lower leg together. Its task is to prevent their displacement.
This important role is played by such ligaments as:
- Interosseous.
- Rear lower.
- Anterior inferior fibular.
- Transverse.
They do not allow the shin to turn inward or outward, fixing the foot.
Second group
It consists of external collateral ligaments, which can be called in one word - deltoid. Their task is to strengthen the outer edge of the tarsus.
This connecting bundle originates in the area of the outer ankle. This is the most powerful connection of the ankle ligaments.
Third group
Based on internal lateral ligaments. The anatomical name is tibiofibular syndesmosis.
Consists of the following tibial ligaments:
- Scaphoid.
- Heel.
- Astragal (anterior and posterior).
They also begin on the inner ankle. Their function is to keep the tarsal bones from displacement and excessive rotation.
Muscular system
The anatomy of the ankle joint cannot be imagined without muscle bundles. They “turn on” the motor activity of the lower leg, ensure stability of the whole body during movement, and are responsible for shock absorption. Directly in this area, there are 8 large muscles, each of which has its own attachment point and role. According to their purpose, the muscles are arranged into specific groups. Thanks to their timely contraction or relaxation, the human body is fixed in a certain position.
For example, the triceps muscle, which is derived from the fusion of the calf muscle, soleus muscle, and plantaris muscle, moves the toes. To help her, the tibia (on the back of the leg) and the finger flexor muscles work.
The opposite actions are carried out by: also the tibial (anterior) and extensors. Other actions of the foot, such as abduction, extension, are provided by the tibialis muscles (short and long). They also participate in pronation and supination in conjunction with the tibia muscles. In the posterior region, the ankle joint is strengthened by the Achilles tendon.
Blood supply
Three branches of blood arteries are responsible for blood circulation and nutrition. Passing through the joint area, they branch into small vascular networks, supplying all parts with blood.
Venous outflow is carried out thanks to the external and internal network of vessels. Closely located vessels form anastomoses (connections).
Lymphatic vessels flow in the direction of the blood vessels, producing lymph outflow.
Video
Video - Anatomy of the ankle joint
Nerve endings
In addition to the blood vessels through the ankle joint area, nerve endings branch:
1. Nerve inside the ankles (tibialis).
2. Nerve on the outside of the ankles (peroneal).
3. Sural nerves.
Any affect nerve endings, especially those on the outer surface.
Possible ankle problems
Many people have experienced ankle problems more than once. This is due to the presence of constant loads, an increased risk of injury, and age-related wear and tear.
Injuries
The largest number, anatomy is to blame.
The most common damage:
- sprains and tears of the connecting link;
- dislocations and subluxations of the leg;
- fractures and cracks of bones.
The leading place in the risk group is given to athletes whose injuries occupy about 10-15% of the total. This is explained by the active work of the lower leg and the high load on the joint in weightlifters. People who play basketball and football often suffer from sprains.
The result of injury is pain, swelling, and the inability to move the limb. Damage varies in severity, which only a doctor can determine.
Important: timely contact with a traumatologist will help avoid serious consequences. An undetected injury to the tibia can result in deformation of the joint cavity.
Inflammation
The development of inflammatory joint diseases is caused by many factors, from injuries and pathologies to age-related changes and heredity.
The most common among them are:
- arthritis that occurs due to injury, infection, or as a concomitant disease (for example, gout);
- osteoporosis – affects cartilage tissue, impairing joint mobility;
- arthrosis – associated with age-related changes. Bone overgrowth (osteophytes) is characteristic;
- tendonitis – characterized by inflammation of the Achilles tendon. Delayed treatment leads to repeated injuries;
- bursitis - changes occur in the synovial bursa, which makes it difficult for the tendons to work.
The pathology is explained by the structure of the ankle joint, which is forced to withstand constant loads.
Factors such as:
- incorrectly selected shoes;
- sedentary lifestyle;
- unbalanced diet;
- advanced age;
serve as a stumbling block on the path to a healthy ankle.
Spinal problems and other diseases
The cause of pain in the lower leg area is often problems of the spinal column.
These include:
When the sciatic nerve is pinched, the pain is concentrated in the buttock area, running along the length of the entire limb to the ankle.
Pain in the ankle area also occurs due to cardiovascular diseases. Blockage of veins (thrombosis) causes severe pain in the ankle joint of a person.
Disruptions in blood circulation provoke insufficient nutrition of tissues. Soreness is also present, although relatively mild.
Diagnosis and treatment
If you have the first signs of a problem (pain, swelling, difficulty moving, redness), you should immediately visit a specialist. After conducting certain diagnostics, the doctor will establish a diagnosis and prescribe appropriate treatment.
Important: self-medication is unacceptable. Incorrectly selected therapy is fraught with serious consequences, including complete immobilization.
Diagnostic methods include: complete blood count, x-ray of the affected area, ultrasound.
Treatment of ankle problems is comprehensive. Drug therapy is complemented by various methods of physiotherapy (mud therapy, electrophoresis). The importance of physical therapy cannot be ruled out. In difficult cases, surgery may be necessary.
The ankle joint is a mobile combination of the foot and lower leg, containing a limited number of bones united by some cartilage and muscles. Among other things, the ankle joint is surrounded by a well-coordinated complex of blood vessels and nerve bundles that support and control its vital functions.
The ankle joint is responsible for performing most of the various maneuvers, reducing stress as much as possible while allowing the foot to remain dynamic.
The ankle joint realizes its existence through the bones - the tibia and fibula and the adjacent talus. The ends of the tibia and the outgrowth of the talus organize the base part of the ankle, where the following divisions are distinguished: the outer malleolus, the plane of the tibia and the inner malleolus.
The outer ankle is divided into anterior and posterior edges and has two planes - external And internal. The connecting territories of the joint in the form of fascia and ligaments are adjacent to the outer surface. The inner plane, together with the area of the talus, merge into the outer fissure of the ankle. There is a process on the inner side of the plane of the tibia.
At the ends of the tibia there are two outgrowths called the anterior and posterior malleolus. The outer edge of the tibia has a notch with projections on both edges. This notch serves as a place for immersion of a limited area of the outer ankle.
The external appendage of the tibia is classified into divisions - anterior and posterior. However, a separate bone formation, called the ridge, separates the medial part of the joint plane from the lateral one. The tubercles, both anterior and posterior, form the inner malleolus. The larger, anterior tubercle is cut off from the posterior tubercle by a notch.
The ankle fascia and ligament attach directly to the medial ankle. The outer part of the ankle and the inner plane of the talus jointly become the inner ankle cleft.
Muscles and blood vessels of the ankle joint
The muscles that allow you to perform diverse maneuverable movements of the foot are concentrated on two planes of the joint - rear And outdoor. They are irreplaceably involved in the coherence of the joint, keeping bones and ligaments in a strictly organized order. They are divided into flexors and extensors.
The tibialis posterior, triceps, plantar, long flexors of the thumb and other toes are all flexor muscles of the foot. In contrast to them, the extensor muscles work, in particular the tibialis anterior, as well as the long extensors of the big and other toes.
Blood supply, along with the muscle corset, constantly protects the life support of the joint. Three main arteries - the peroneal, anterior and posterior tibial - supply the ankle tissue with all the necessary substances. Near the joint capsule, ankles and ligaments, an organized network of vessels flows, caused by the branching of the arteries.
The intake of waste liquids, enriched with carbon dioxide and decay products, moves through various vessels, ultimately converging into veins: tibial and subcutaneous.
Ankle injuries and diseases, prevention
Due to the constant, incessant, and often exceeding permissible norms load on the ankle joint, injuries and diseases occur with enviable regularity. The bony and connective divisions of the joint, and sometimes its nervous component, may be affected.
Commonly diagnosed lesions include:
- Arthritis. A particularly popular ailment of the ankle joint. The most common harbingers are: infectious lesions, gout, trauma, autoimmune diseases, old age.
- Ankle fracture. According to statistics, it is one of the ankle injuries regularly diagnosed by surgeons. It occurs mainly in professional athletes, children, elderly people, as well as people involved in ballet or dancing.
- Carpal tunnel syndrome. A disease of the nervous system caused by damage to the posterior tibial nerve. The disease progresses to damage to the Achilles, which is fraught with rupture and the need for surgical intervention.
- Sprains, sprains, subluxations of the ankle. Injuries most often affecting the health of athletes, dancers, stunt performers, children and the elderly. The causes of injuries can be: incorrect foot placement during physical activity, neglect of protective equipment, unsuccessful landing, falling in icy conditions, sudden change in foot position.
Prevention of joint injury involves the following measures:
- Playing sports in special shoes, using protective equipment when cycling, rollerblading, skating, snowboarding.
- Limited wearing of shoes with heels, high platforms, and shoes without foot support or lack of arch support, such as open clogs or sandals.
- Regular physical activity on the ankle, including joint exercises, physical therapy, mandatory warm-up before playing sports.
- Physiotherapy for ankle injuries or related occupational activities affecting the joint. Iontophoresis, magnetic therapy, various baths, mud therapy, electrophoresis, and massage are used.
- Go to the hospital if you have a joint injury, as well as symptoms such as pain, crunching, cracking, loss or limitation of mobility, loss of sensitivity, swelling and hematomas.
- Inclusion in the diet of vitamin and mineral complexes designed to make joint function satisfactory, especially in old age, when chronic joint diseases are detected and injuries are present.
- No hypothermia of the joint due to the need to preserve nerve endings. You should avoid long swims in cold water, dress appropriately for the weather, avoid hypothermia, and if there is such, warm your feet as quickly as possible by rubbing or taking a hot bath.