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Ankle Joint - 3D Anatomy Tutorial
 
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http://www.anatomyzone.com 3D anatomy tutorial on the ankle joint using the Zygote Body Browser (http://www.zygotebody.com). Join the Facebook page for updates: http://www.facebook.com/anatomyzone Follow me on twitter: http://www.twitter.com/anatomyzone Subscribe to the channel for more videos and updates: http://www.youtube.com/subscription_center?add_user=theanatomyzone
Views: 242981 AnatomyZone
Ankle Ligaments Anatomy - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim’s educational animated video describes the anatomy of the ankle ligaments. The ankle joint is made of three bones, the tibia, the fibula and the talus. The tibia is the major bone of the lower leg which bears the majority of the body weight. At the angle, the bump of the tibia forms the medial malleolus. The fibula is the smaller of the two bone of the leg. The lateral end of the fibula forms the lateral malleolus. In the ankle joint the talus articulates with the tibia. The talus is involved in multiple movements of the foot. There are ligaments in the ankle that provide connections between the bones. Injury to any of these ligaments may occur when the foot twists, rolls or turns beyond its normal motion. An ankle sprain is a common injury that occurs in sports as basketball and soccer. The deltoid ligament is on the medial side. It is formed of four parts: anterior tibiotalar part, tibionavicular part, tibiocalcaneal part and the posterior tibiotalar. The superficial deltoid arises from the anterior colliculus. The deep deltoid arises form the posterior colliculus and the intercollicular groove. The deltoid ligament is the main stabilizer of the ankle joint during the stance phase. The deltoid ligament is rarely injured by itself and it is usually associated with fractures. There are 3 lateral ligaments of the ankle joint: The anterior talofibular ligament (weakest): origin: 10 mm proximal to the tip of the fibula. Extends from the anterior inferior border of the fibula to the neck of the talus. The posterior talofibular ligament ( strongest): origin from the posterior border of the fibula. Inserts into posterolateral tubercle of the talus Calcaneofibular ligament: origin anterior border of the fibula 1 cm proximal to the distal tip. Inserts into the calcaneus distal to the subtalar joint and deep to the peroneal tendon sheath. The lateral ligaments are the most commonly injured ligaments in the ankle. The ligament of the syndesmosis •Anterior inferior tibiofibular ligament •Interosseous ligament •Posterior inferior tibiofibular ligament The connection of the tibia and fibula is called the syndesmosis. High ankle sprain = syndesmosis injury 5-10%. Injury of the ligaments above the ankle. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC
Views: 67721 nabil ebraheim
Ankle & Subtalar Joint Motion Function Explained Biomechanic of the Foot - Pronation & Supination
 
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Biomechanic Reference: http://astore.amazon.com/nichogiovi-20 Popular Running Shoes: http://astore.amazon.com/nichogiovi-20?_encoding=UTF8&node=2 Dr. Glass DPM Podiatry Resource Network [email protected] www.drglass.org This video illustration depicts the ankle joint complex which includes the tibial talar and subtalar joint in human anatomy. Dr. Glass DPM - This is an illustration that depicts the cardinal plane movements of the lower extremity. This is a biomechanical demonstration of the functional orthopedic nature of podiatry
Views: 657444 DrGlassDPM
Ankle Anatomy Animated Tutorial
 
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In this animated episode of eOrthopodTV, orthopaedic surgeon Randale Sechrest, MD discusses the anatomy of the ankle joint.
Views: 646130 Randale Sechrest
Talocrural Joint Manipulation - Bill Temes
 
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Bill Temes shows us how to perform a distraction manipulation of the Talocrural Joint. This video is a part of a video series titled "The Lower Quadrant." Get the video and sign up for our newsletter and receive regular videos at www.naiomt.com.
Views: 7851 NAIOMT1
Foot Bones explained | Foot joints and ankle movements | Human Anatomy in 3D | elearnin
 
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Foot Bones explained | Foot joints and ankle movements | Human Anatomy in 3D | elearnin This video illustrates one of the most used parts of human body, the foot. Understand the intricacies of the movements of the feet by getting familiar with the joints and bones which make the feet, and the set of complex muscles which make it so easy for humans to move their body. The foot, the plural of which is feet, is a structure found in many vertebrates, typically associated with the hind limbs, is responsible for the movement of the mammals. Foot is the last portion of a leg in most mammals, as it bears weight. The human foot and ankle combination is the strongest complex structure with 26 bones, 33 joints and number of ligaments and tendons. The foot lies below the ankle joint. The foot is a five toed organ which supports the body in the standing and moving forward and backwards. The skeleton of the foot begins with the ankle bone. The bones of the lower leg join together at the ankle joint. At this joint, the feet form a stable structure that holding them in a firm position. The bones that are in the back part of the foot are called the heel bones. Calcaneus, also known as heel bone, is the large bone that forms the foundation of the rear part of the foot. This heel bone connects the ankle bone, also known as the talus, with the cuboid bones. The connection between the talus and calcaneus forms the sub talar joint. This sub talar joint is very crucial for the normal foot function and allows the foot to move sideways. The tarsal bones are set of five bones that work together as a group. These bones fit uniquely with other, especially, the way they lock and unlock themselves when the foot moves from one direction to the other. The ankle joint acts as the pivotal joint for the movement of the foot and helps the foot to bend up and down. There are ligaments in the leg which are soft tissues that attach one bone to another and are very similar to tendons. The only difference between them is that the tendons attach muscles to bones. The Achilles tendon is the most important tendon in the foot which is essential for walking, running and jumping. This tendon helps us stand and rise up and down on toes. Most of the muscles of the foot are arranged in the layers on the sole of the foot. There are also tendons that provide padding underneath the sole. The main nerve to the foot is the tibial nerve. It supplies sensation to the toes and sole of the foot and controls their muscles. The main blood supply to the foot runs right beside the posterior larger nerve. Several less important arteries enter the foot from the other directions By the way, if you haven't yet, do Subscribe to our channel, elearnin, for latest update on high-end 3D Anatomy videos.
Views: 86938 Elearnin
Scanning Technique: Ultrasound-Guided Foot Injection - SonoSite
 
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Visit http://www.sonosite.com/education/ Demonstration of aspiration or injection of the ankle under ultrasound guidance, including probe type, probe position, projected needle path and key anatomy viewed during the exam. Visit http://www.sonosite.com/education/
Views: 57817 SonoSite
Anterior Drawer Test of the Ankle | Chronic Ankle Laxity & Anterior Talofibular Ligament Rupture
 
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DOWNLOAD OUR APP: 📱 iPhone/iPad: https://goo.gl/eUuF7w 🤖 Android: https://goo.gl/3NKzJX GET OUR ASSESSMENT BOOK ▶︎▶︎ http://bit.ly/GETPT ◀︎◀︎ This is not medical advice. The content is intended as educational content for health care professionals and students. If you are a patient, seek care of a health care professional. The anterior drawer test has limited diagnostic ability for chronic ankle laxity but performs well in an acute situation to diagnose ruptures of the anterior talofibular ligament commonly injured after ankle inversion trauma  HELP TRANSLATE THIS VIDEO  If you liked this video, help people in other countries enjoy it too by creating subtitles for it. Spread the love and impact. Here is how to do it: https://youtu.be/b9cKgwnFIAw  SUPPORT US  : http://bit.ly/SPPRTPT  ARTICLES: Croy (2013): https://www.ncbi.nlm.nih.gov/pubmed/24175608 Van Dijk (1996): https://www.ncbi.nlm.nih.gov/pubmed/9065068 Miller (2016): https://www.ncbi.nlm.nih.gov/pubmed/26660862 Visit our Website: http://bit.ly/web_PT Like us on Facebook: http://bit.ly/like_PT Follow on Instagram: http://bit.ly/IG_PT Follow on Twitter: http://bit.ly/Tweet_PT Snapchat: http://bit.ly/Snap_PT
Views: 76207 Physiotutors
ankel fusion with screw through the anterior approach
 
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educational and entertainment channel in the field of orthopedic surgery and sometimes other surgical or medical fields.
TALONAVICULAR JOINT
 
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Views: 2839 Tarsal Joints
Ankle and Subtalar Joint Range of Motion Assessment
 
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Demonstration of the assessment of the range of motion at the ankle and subtalar joints.
Views: 20074 Jason Craig
The Talar Tilt Test | Lateral Ankle Sprain
 
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DOWNLOAD OUR APP: 📱 iPhone/iPad: https://goo.gl/eUuF7w 🤖 Android: https://goo.gl/3NKzJX GET OUR ASSESSMENT BOOK ▶︎▶︎ http://bit.ly/GETPT ◀︎◀︎ This is not medical advice. The content is intended as educational content for health care professionals and students. If you are a patient, seek care of a health care professional. The Talar Tilt Test may be used to assess a lateral ankle sprain and the integrity of the talofibular and deltoid ligaments. Article: www.ncbi.nlm.nih.gov/pubmed/10589849 Visit our Website: http://bit.ly/29xmSzV Like us on Facebook: http://bit.ly/29GyogP Follow on Instagram: http://bit.ly/29HN0Lp
Views: 133204 Physiotutors
Subtalar Joint Manipulation - Bill Temes
 
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NAIOMT Faculty Member Bill Temes demonstrates and effective subtler joint manipulation. Sign up for our newsletter and receive regular videos at www.naiomt.com.
Views: 35593 NAIOMT1
Ankle Pain Complete Overview - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim’s educational animated video describes the anatomy of the anterior compartment of the foot, and the injuries and conditions associated with the ankle. There are many structures present at the anterior aspect of the ankle. These structures are often susceptible to injury. Common injuries and conditions around the anterior ankle 1-Anterolateral impingement: Painful limitation of full range of ankle motion due to soft tissue or osseous pathology. Soft tissue thickening commonly seen in athletes with prior trauma that extends into the ankle joint. Tibial bone spur impinging on the talus can become a source of chronic ankle pain and limitation of ankle motion in athletes. 2-Arthritis of the ankle joint: Commonly the result of a prior injury or inflammation to the ankle joint. Can be usually diagnosed with an examination and x-ray. 3-Osteochondritis dissecans of the talus: Chip type fracture that usually occurs with severe ankle sprains. Causes pain, swelling, and stiffness of the ankle joint. X-rays, Ct scan or MRI are commonly used for the diagnosis. 4-Tibialis anterior tendonitis 5-Anterior tibialis tendonitis: It is an overuse condition common in runners. Common injury that usually accompanies anterior shin splints. If this tendon is strained, pain and tenderness will be felt upon active dorsiflexion or when the tendon is touched. There are many structures present at the medial aspect of the ankle. These structures are often susceptible to injury. Common injuries and conditions around the medial ankle 1-Posterior tibial tendonitis or rupture: Posterior tibial tendon problems can occur from overuse activities, degeneration and trauma. The posterior tibial tendon is one of the major supporting structure of the foot. The tendon helps to keep the arch of the foot in its normal position. When there is insufficiency or rupture of the tendon, the arch begins to sag and a flatfoot deformity can occur with associated tight achilles tendon. This occurs distal to the medial malleolus. This area is hypovascular. It presents with painful swelling on the posteromedial aspect of the ankle. Patient is unable to perform a single leg toe raise. 2-Tarsal tunnel syndrome: It is compression of the tibial nerve in the tarsal tunnel. The flexor retinaculum covers the nerve. Tarsal tunnel syndrome is similar to compression of the median nerve in the carpal tunnel. Causes include ganglia, accessory muscle and soft tissue mass. 3-Flexor hallucis tendonitis: Pain, swelling, weakness posterior to the medial malleolus. Dorsiflexion of the big toe may be reduced when the ankle is placed in dorsiflexion. Triggering and pain along the tendon sheath may also occur with toe flexion. It often occurs in activities such as ballet dancing, in which plantar flexion is necessary. 4-Rupture of the deltoid ligament: The deltoid ligament are the primary stabilizers of the ankle joint. The deltoid ligaments provide support to prevent the ankle from everting. An isolated eversion sprain with tear of the deltoid ligaments is a rare injury. There are many structures present at the posterior aspect of the ankle. These structures are often susceptible to injury. Common injuries and conditions around the posterior ankle 1-Posterior ankle impingment (os trigonum): It is nonunited piece of accessory bone seen posterior to the talus. It is common among athletes such as ballet dancers. Tenderness in the posterolateral aspect of the ankle posterior to the peroneal tendon especially with passive plantar flexion. May be seen in association with flexor hallucis longus tenosynovitis. 2-flexor hallucis longus tenosynovitis: It is a condition associated with ballet dancing, in which extreme plantar flexion is necessary. Swelling and pain posterior to the medial malleoulus. Triggering with toe flexion. Dorsiflexion of the big toe is less when the ankle is dorsiflexed. 3-Achilles tendonitis: Irritation and inflammation due to overuse. Pain, swelling and tears within the tendon. Usually treated with therapy and injection. Do not inject inside the tendon, rarely treated with surgery. 4-Achilles tendon rupture: Achilles tendon can become prone to rupture with age lack of use, or by aggressive exercise. Rupture is diagnosed by the Thompson test and MRI. Treatment may be conservative without surgery by using a cast or a boot , however the rerupture rate is high. Surgery is done by approximation of the torn ends, however there is a risk of infection, skin and wound complications with surgery. There are many structures present at the lateral side of the ankle. These structures are often susceptible to injury. Diagnosis of these injuries can be confusing and many of these injuries can be missed.
Views: 455113 nabil ebraheim
Osteopathic Manipulation (Chiropractic Adjustment) of the TIbiotalar Joint HVLA
 
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http://www.facebook.com/StefanDuellSportsPhysiotherapy Regarding my previous post about myofascial treatment of the inversion trauma, it is very important to correct the tibiotalar joint if it is still in the wrong position. Usually if you do a proper myofascial release treatment it will correct itself but sometimes it can still stay in the wrong place. If so, there is a high chance to suffer from an ankle dorsiflexion range of motion (DO ROM) deficit which can be reduced significantly through this kind of manipulation! ⚠️But watch out: never do this manipulation in the acute phase of an inversion trauma as it can lead to an internal bleeding and edema. To be on the secure side you can apply the HVLA thrust technique 4-5 days after the injury happened‼️ . The tibiotalar joint involves the talus moving in the ankle mortise, the major motions of this joint are dorsiflexion and plantarflexion. Dorsiflexion is more functional, more stable because the talus is wider anteriorly and fits securely into the ankle mortise. Reduction in dorsiflexion usually indicates that the tibia is anterior on the talus. The talus usually subluxates anteriorly, superiorly with medial rotation. To reduce the talus subluxation your contact will be on the anterior medial neck of the talus, the elbows will be parallel to each other, the therapist stands in a stable position and applies an high velocity low amplitude thrust technique.
Views: 554 StefanDuell
Ankle Ligament Injury Tests & Assessment - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim’s educational animated video describes the ligaments of the Ankle. An ankle sprain is usually low ankle sprain, but occasionally high ankle sprain. Other conditions associated: •Osteochondral lesion •Peroneal tendon subluxation •Lateral process fracture of the talus •Anterior process fracture of the calcaneus •High syndesmotic injury Tests for injury of these ligaments: •Anterior drawer test •Squeeze test •External rotation stress test •Talar tilt test (inversion test). If the patient can’t bear weight on the ankle, the patient should get an x-ray. Injury to the deltoid ligament occurs on the medial side of the ankle joint and usually associated with fracture. Injury to the lateral side ligament is referred to as ankle sprain. The anterior tibiofibular ligament is the west on the lateral side. Anterior drawer test: is done to test the competency of the anterior tibiofibular ligament. The test is done in 20 degrees of plantar flexion and compares it to the other side. A shift of an absolute value of 9 mm on the lateral x-ray or 5mm compared to the other side is positive. The calcaneofibular ligament is usually injured after the anterior talofibular ligament. talar tilt test: less than 5 degrees of tilt is usually normal. A high ankle sprain may require surgery. Always track the fibula proximally to avoid missing a Maisonneuve fracture. Squeeze test is used to diagnose high ankle sprain. By squeezing the tibia and fibula at the mid-calf this causes pain at the syndesmosis if high ankle sprain is present. External rotation stress test: place the ankle in a neutral position, then apply external rotation stress and get a mortise view radiograph. The positive result if the tibiofibular clear space is more than 5 mm. there is also a positive result if the medial clear space is more than 4 mm. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC
Views: 97236 nabil ebraheim
Common Foot And Ankle Injections - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim’s educational animated video describes injection techniques for painful conditions of the foot and ankle. Conditions which cause pain and inflammation are treatable with the use of diagnostic and therapeutic injection. Ankle joint The ankle joint is formed by the articulation of the tibia and talus. Injection is done to alleviate pain occurring from trauma, arthritis, gout or other inflammatory conditions. Anterolateral ankle impingement •Can occur due to the build-up of scar tissue in the ankle joint or from the presence of bony spurs. •With the ankle in a neutral position, mark the injection site just above the talus and medial to the tibialis anterior tendon. •The injection site is disinfected with betadine. •The needle is inserted into the identified site and directed posterolaterally. •Injection of the solution into the joint space should flow smoothly without resistance. •Pulling on the foot to distract the ankle joint is helpful. First metatarsophalangeal joint •The MTP joint is a common injection site frequently affected by gout and osteoarthritis. •The injection site is disinfected with betadine. •The needle is inserted on the dorsomedial or dorsolateral surface. •The needle is angled to 60-70 degrees to the plane of the match the slope of the joint. •Injection of the solution into the joint space should flow smoothly without resistance. •Pulling on the big toe is sometimes helpful in distraction of the joint. Peroneal tendonitis •Peroneal tendonitis is an irritation to the tendons that run on the outside area of the ankle, the peroneus longus and peroneus brevis. •The injection site is disinfected with betadine. •Insert the needle carefully in a proximal direction when injecting the peroneus brevis and longus tendon sheath. •Advance the needle distally to inject the peroneus brevis alone at its bony insertion. Achilles tendonitis •Achilles tendonitis is irritation and inflammation of the large tendon in the back of the ankle. Achilles tendonitis is a common overuse injury that occurs in athletes. •Injection of steroid should be given around the tendon, not through the tendon. •Injections directly into the tendon is not recommended due to increased risk of tendon rupture. •Platelets injection can be done through the tendon with needling and fenestration. Tarsal tunnel syndrome •The condition of pain and paresthesia caused by irritation to the posterior tibial nerve. •Feel the pulse of the posterior tibial artery, the nerve is posterior, find the area of maximum tenderness, 1-2 cm above it will be the injection site that is marked on the medial side of the foot and disinfected with betadine. •The solution is injected at an angle of 30 degrees and directed distally. •Warn the patient that the foot may become numb. •Care should be taken In walking an driving. •Usually performed after a treatment program which can include rest, stretching and the use of shoe inserts. Plantar fasciitis •The plantar fascia is a band of connective tissue deep to the fat pad on the plantar aspect of the foot. •Patients with plantar fascia complain of chronic pain symptoms that are often worse in the morning with walking. •The injection site is identified and marked on the medial side of the foot and betadine used. •Avoid injecting through the fat pad at the bottom of the foot to avoid fat atrophy. •The needle is inserted in a medial to lateral direction one finger breathe above the sole of the foot in a line that corresponds to the posterior aspect of the tibia. •The solution is injected past the midline of the width of the foot.
Views: 113500 nabil ebraheim
Current Concepts In Foot & Ankle Injuries - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim animated educational video describing current concepts of foot and ankle injuries. I.Ankle fractures a.Supination-external rotation i.Vertical fractures of medial malleolus is bad ii.Differentiate between supination/external rotation and pronation/external rotation by lateral x-ray to see the direction of the fracture b.Isolated lateral malleolar fracture i.Nondisplaced with no talar shift can be treated conservatively. ii.Displaced fracture with talar shift will require surgery. c.Weber C fractures i.Syndesmotic injuries are common II.Ankle fractures & diabetes a.Surgery is better in diabetics III.Pilon fracture (tibial plafond) a.Axial load, high energy injury. Can occur due to a fall or from a car accident. i.medial malleolar fragment ii.Anterolateral fragment: chaput fracture iii.Posterolateral fragment: Volkman fracture (posterior inferior tibiofibular ligament is attached to this fragment) IV.Treatment of displaced fractures: a.Delay open reduction internal fixation until the skin condition improves. b.Soft tissue complications: you need to get skin wrinkles before you do internal fixation. c.Joint fusion surgery (arthrodesis) for arthritis: not commonly used or needed. V.Navicular fractures a.Stress fracture of the navicular is the important one and usually occurs in the central third. b.Treatment: Cast and non-weight bearing. Do ORIF in athletes, if there is a nonunion, or failure of conservative treatment and also in displaced fractures of the navicular. VI.5th metatarsal base fractures a.Zone I: proximal tubercle avulsion fracture. Treatment of zone I proximal tubercle fracture Is usually nonoperative (use a boot or a fracture shoe). b.Zone II (jones fracture) at the 4th and 5th metatarsal articulation which is the junction between the metaphysis and the diaphysis. c.Zone III proximal diaphysis fracture VII. Open calcaneal fractures a.Open fractures of the calcaneus may lead to amputation. There are two basic fragments: i.anteromedial (sustentacular) fragment ii.posterolateral (tuberosity) fragment VIII.Talus fractures (Hawkin’s classification) a.Type I: non-displaced. 10% AVN b.Type II: fracture with subtalar dislocation or subluxation. 50% AVN. c.Type III: fracture with subtalar and tibiotalar subluxation or dislocation. 90% AVN. d.Type IV: fracture with subtalar and tibiotalar dislocation and talonavicular subluxation. 90-100% AVN. Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund: https://www.utfoundation.org/foundation/home/Give_Online.aspx?sig=29
Views: 52046 nabil ebraheim
Medial Ankle Ligaments
 
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Views: 101920 Catherine Blake
Ankle Palpation
 
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http://www.p2sportscare.com to learn prevention methods. We specialize in sports injuries and getting athletes back to their sports fast (running injuries, shoulder tendonitis, IT Band, Runners Knee, Hip Flexor tightness). We see athletes anywhere from baseball, triathletes, golfers, basketball, cyclist, runners and so on. We provide Active Release Techniques (ART), chiropractic care, strength training and corrective exercises. The Performance Place Sports Care is located in Huntington Beach, CA. 714-502-4243 Ankle impingement by an osseous growth, spur, can be the main source of pain with many biomechanical and functional movements. Anatomically the ankle is composed of three joints: talocrural joint, subtalar joint, and inferior tibiofibular joint. The ankle joint is special in that all surfaces of the joint are covered in articular cartilage, which can be a mechanical disadvantage if injured. Cartilage as a whole does not have neural or vascular supply, therefore any injury to the cartilage will not be able to heal properly. If enough cartilage damage is done to the level of the subchondral bone, an area of vascularity, it is possible that some of the articular cartilage may be healed with fibrocartilage. Although fibrocartilage indicates healing in the ankle joint, it has decreased biomechanical benefits and can lead to impingement. Typically articular cartialge will not induce pain, due to the lack of neural input. However, if pain is felt after the ankle swelling has reduced, it is likely the pain is referred from another source such as an osseous spur. The ankle joint is surrounded by many ligaments that hold all of the boney attachments together. Functionally speaking, the ankle is a joint of mobility and is the key player in determining the functionality for all the other major joints of the body. Athletes who have difficulty moving their ankle through ranges of motion or have pain upon movement can possibly have a restricted ankle joint, but the main cause is due to poor biomechanics from a previous overuse injury and fatiguing of the soft tissue. Among the ligaments found in the ankle, the strongest ligament of the ankle joint is the deltoid ligament, found on the inside. The other three ligaments, anterior and posterior talofibular ligaments, and calcaneofibular ligaments are found laterally and the area of insult with a classic inversion ankle sprain. Once the ankle is malpositioned, the ligaments become lax and unstable in efforts of preventing dysfunctional movement. Ankle sprains are usually caused by intense, repetitive movements applying too much pressure to the muscles and joints. The ankle is found to be most stable in the closed pack position, dorsiflexion, and most injuries are attained with plantar flexion. Running, ice skating, plyometric exercise are all activities with repetitive ankle motion and can lead to injury. When observing the ankle for motion, the patient may experience pain through the ranges of motion, which is a good indicator of an impingement and there is some sort of restriction in the soft tissue or in the joint. To fully diagnose a healed ankle with dyskinesis or pain imaging should also be considered in diagnosis to rule out any osseous fracture, joint degeneration, impingement from an osseous structure, or arthritis in the joint. The best source of imaging for the ankle joint is an arthroscopy. If a sprain is concluded another source of imaging would be a musculoskeletal ultrasound to further evaluate the scar tissue in the soft tissue preventing full range of motion in addition to pain upon exertion. Possible treatments for ankle impingement: - Active Release Technique - Graston - Eccentric rehabilitative exercises - Stretching - RICE (rest, ice, compress, elevate) - Surgery based on the severity of the tear to reattach the muscle tendon - Steroid injections - Non-Steroidal Anti-Inflammatory medications ankle impingement, impingement of ankle, impingement syndrome, ankle pain, pinch in ankle, ankle sprain, sprained ankle, rolled ankle, ankle therapy, ankle treatment, ankle physiotherapy, physiotherapy, chiropractic, sports chiropractor, huntington beach chiropractor, physiotherapist, peroneal tendonitis, atfl, ligament tear, tibialis positerior, tibialis anterior
Views: 37888 Sebastian Gonzales
Ankle Pain, ankle ligaments sprain - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim’s educational animated video describes conditions and treatment methods associated with pain of the ankle. High ankle sprain •A high ankle sprain is a sprain of the syndesmotic ligaments that connect the tibia and fibula at the ankle. •Diagnosis of syndesmotic injury is usually done by the use of external rotation stress view examination or CT scan. This patient may require surgery. Anterolateral impingment •Painful limitation of full range of ankle motion due to soft tissue or osseous (bony) pathology. •Soft tissue thickeneing commonly seen in athletes with prior trauama that extends into the ankle jint. •Arthroscopy of the ankle may be helpful . •Tibisl bone spur impinging on the talus can become a source of chronic ankle pain and limitation of ankle motion in athletes. Osseous (bony) spur on the anterior lip of tibia contacting the talus during dorsiflexion. The patient may need debridment of the spur. Ankle sprain •Pain that is anterior and around the fibula can usually be attributed to a ligament sprain. •Sprains result from the stretching and tearing (partial or complete) of small ligaments that can become damaged when the ankle is forced into an unnatural position. •Treatment includes immobilization, ice therapy, physical therapy and rarely surgery. •With ankle sprain, the patient will be able to walk, but it will be painful. With a fracture, the patient will be unable to walk. Pain that is posterior to the fibula can usually be attributed to an injury of the peroneal tendons. Lateral ankle pain •Patients with peroneal tendon problemes usually describe pain in the outer part of the ankle or just behind the lateral malleolus. •Problems mainly occus in the area where the tendons of the two muscles glide within a fibrous tunnel . Peroneal inflammation/ tendonitis •Tendons are subject to excessive repetitive forces causing pain and swelling. •Peroneal tendon subluxation •Usually occurs secondary to an ankle sprain with retinaculum injury. •Occurs with dorsiflexion and usually eversion of the ankle. Posterior anle pain Achilles tendonitis •Irritation and inflammation due to overuse. •Pain, swelling and tears within the tendon. •Achilles tendon can become prone to injury or rupture with age, lack of use or by aggressive exercises. •The Thompson test is performed to determine the presence of an Achilles tendon rupture. A positive result for the thompson’s test is determined by no movement of the ankle while squeezing of the calf muscles. Posterior ankle impingment •Os trigonum or large posterior process of talus (stieda syndrome) •Common among athletes such as ballet dancers. •May be seen in association with flexor hallucis longus tenosynovitis. Tarsal tunnel syndrome •Compression or squeezing on the posterior tibial nerve that produces symptoms of pain and numbness on the medial area of the ankle. •When conservative treatment methods fail, surgical treatment or tarsal tunnel release surgery may be needed. Posterior tibial tendon tears are one of the leading causes of failing arches (flatfoot) in adults. •Too many toes sign •Loss of medial arch height •Pain on the medial ankle with weight bearing Arthritis of the ankle joint •Commonly the result of a prior injury or inflammation to the ankle joint. •Can usually be easily diagnosed with an examination and x-ray. Osteochondral lesion of the talus •Arthroscopic debridment may be necessary. Please go to the following link and support the artist Johnny Widmer in his art contest - Sign to Facebook and click LIKE https://www.facebook.com/marlinmag/photos/a.10153261748858040.1073741838.134227843039/10153261754338040/?type=3&theater Thank you! https://www.facebook.com/JohnnyWidmerArt?fref=ts http://www.johnnywidmer.com/
Views: 609282 nabil ebraheim
Ankle Joint Injection
 
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This is a step-by-step instructional video on injection of the ankle (tibiotalar) joint using an anteromedial approach.
Views: 55 Medical Education
Subtalar Joint Range of Motion With Foot Skeleton
 
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Dr. Kirby demonstrates the gliding articular motions of the talus and calcaneus during subtalar joint pronation and supination. The maximally pronated position of the subtalar joint occurs when the lateral process of the talus drops down into the floor of the sinus tarsi of the calcaneus and is stopped by interosseous contact forces. Subtalar joint supination causes an increase in the volume of the sinus tarsi since the lateral process of the talus is moving away from the floor of the sinus tarsi of the calcaneus. Sinus tarsi syndrome occurs when the interosseous compression forces between the lateral process of the talus and the floor of the sinus tarsi of the calcaneus are increased in patients with more severe medial subtalar joint axis deviation and/or with painful scar tissue within the sinus tarsi from inversion ankle sprains or other traumatic pathologies.
Views: 12523 Kevin Kirby
Ankle: posterior subtalar joint effusion assessment
 
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www.mskultrasound.cl The ultrasonographic assessment of the ankle and foot is full of details. Many joints and ligaments in a narrow area. The posterior subtalar joint is one of them. I share a "trick" to better evaluate this articulation and not overlook effusions that can slip away from our probe.
Views: 157 MSK Ultrasound
PLANTAR CALCANEO-NAVICULAR LIGAMENT
 
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it is attached to the plantar surface of navicular bone and sustantaculum tali of calcaneum... also termed as spring ligament.
Views: 4752 viren kariya
The best exercise to improve ankle joint movement
 
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• What is ‘normal’ ankle joint dorsiflexion? Ankle dorsiflexion is movement at the ankle where, if the foot is not fixed to the floor, the foot will move up towards the leg, or if the foot is fixed to the floor (as in gait), the tibia moves forward over the foot. There is no definitive value in the literature as to the ‘normal’ range of ankle dorsiflexion and this is largely due to the fact that some studies use a weight-bearing assessment of ankle movement while others use a non-weight-bearing assessment. There is however a general consensus that a weight-bearing lunge test is the simplest and most reliable test to assess ankle joint dorsiflexion. A measurement of 10-12 cm of the foot from the wall, or a 35-38 degree angle of the tibia are considered to be minimum measurements needed to allow for ‘normal’ function of the lower leg during gait. • What can restrict ankle dorsiflexion? The most common cause of restricted ankle dorsiflexion is tight posterior muscles, usually the gastrocnemius and soleus. A bony block may also limit ankle movement. An abnormally shaped talus or an anterior exostosis (abnormal bony protrusion) will potentially block movement of the tibia forward over the talus (the bone in the foot that articulates with the tibia). A tight joint capsule or tight posterior ligaments (tibiotalar and talofibular) can also limit dorsiflexion. • What happens if I don’t have enough ankle dorsiflexion? Maggs (2015) has reviewed the literature that examines the effects of reduced ankle dorsiflexion on function of the lower limb. There are 6 main outcomes suggested in the research. 1) decreased knee flexion 2) increased knee valgus (where the knee moves towards the midline of the body) 3) increased pronation of the subtalar joint allows for increased dorsiflexion movement at the midtarsal joint in order to compensate for reduced ankle dorsiflexion 4) increased hip flexion and forward lean of the trunk 5) increased ground reaction force (energy coming up from the ground through the foot during gait) 6) impaired balance. Several studies have looked for a correlation between reduced ankle dorsiflexion and injury. Two studies (Backman & Danielson (2011) and Malliaras et al (2006)) found a correlation between reduced ankle dorsiflexion and patellar tendinopathy. Willems et al (2005) and Pope et al (1998) were both prospective studies that found subjects with reduced ankle dorsiflexion were at five times the risk of ankle sprain. The research is less clear on the contribution of reduced ankle dorsiflexion to the development of plantar fasciitis. It does however make sense that as the midfoot plantarflexes to compensate the plantar fascia will be placed under strain, and most treatment plans for plantar fasciitis will include an Achilles stretching regime. • How can I increase ankle joint dorsiflexion? Traditionally a static calf stretch (assuming a stretch and holding it for 20-30 seconds) has been prescribed to improve ankle dorsiflexion range. However a dynamic exercise, such as Mulligan’s ankle mobilisation, is thought to not only increase ankle dorsiflexion range but also reduce stiffness of the movement. The exercise program follows: o Loop a resistance band around a table leg and then around the leg to be stretched. The band should sit below both malleoli (protruding ankle bones) and act to block forward movement of the talus during the exercise. o Then perform a lunge where the knee should be moved forward over the toes. o Two to three sets of 10-12 reps should be performed daily.
Views: 2819 Hunter Podiatry
How to treat an Ankle Inversion Sprain - Kinesiology Taping to stabilise ligaments
 
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http://www.johngibbonsbodymaster.co.uk/courses/ John Gibbons is a sports Osteopath and a lecturer for the 'Bodymaster Method ®' and in this video he is demonstrating how to apply Kinesiology tape for a patient that presents with an Ankle Inversion sprain. Want to learn how to apply Athletic Tape as well as other Physical Therapy CPD Courses then look on http://www.johngibbonsbodymaster.co.uk John is also the Author of the highly successful book and Amazon No 1 best seller, called 'Muscle Energy Techniques, a practical guide for physical therapists'. John has also written 2 more books, one is called 'A Practical Guide to Kinesiology Taping' and this comes with a complimentary DVD and the other book is called; 'Vital Glutes, connecting the gait cycle to pain and dysfunction'. These 2 books are available to buy now through his website http://www.johngibbonsbodymaster.co.uk/books/ or from Amazon http://www.amazon.co.uk John now offers Advanced Training in all aspects of Sports Medicine to already qualified therapists in manual therapy to 'Diploma' Level. You need to have attended all of his Physical Therapy Courses before the diploma is awarded. His venue is based at the idylic venue of Oxford University, home of the first four-minute mile by Roger Bannister.
Views: 939369 John Gibbons
Sports Ultrasound of the Midfoot
 
01:00:05
In this video, done in partnership with AMSSM, Jonathan Finnoff, DO, describes the sonographic features of a tarsal fracture; identifies sonographic abnormalities associated with a spring ligament sprain; discusses the sonographic evaluation of Lisfranc joint sprains; and helps you understand the etiology of jogger's foot. Interested viewers may be able to earn CME credit. If available, it is located here: http://www.aium.org/cme/testsWebinar.aspx. Original air date: 8/24/2017
Views: 2974 AIUMultrasound
Bipolar Osteochondral Allograft Transplantation of the Tibiotalar Joint for Ankle Arthritis
 
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Bipolar osteochondral allografting is a technically complex procedure envisioned as an alternative to arthrodesis or arthroplasty in carefully selected young patients with advanced tibiotalar arthritis, usually as a result of trauma. Arthrodesis or implant arthroplasty is virtually contraindicated in these patients. Allograft transplantation is considered as an alternative to arthrodesis in a younger person with tibiotalar arthritis. The advantages of allografting over arthrodesis are relative preservation of joint motion that may provide higher function and longer preservation of surrounding midfoot and hindfoot joints than is seen after arthrodesis. The main potential advantages of allograft surgery are predictable pain relief, maintenance of tibiotalar joint function, and ease of conversion to other reconstructive procedures at a later date. Disadvantages include relatively high reoperation and failure rates. Perhaps the most influential characteristic in determining the choice of allografting over arthrodesis is the patient’s decision-making. Virtually all patients undergoing allografting have been offered arthrodesis but, after careful consideration, have a strong desire to avoid arthrodesis and accept the higher reoperation rate and relative long-term uncertainty of the allograft procedure. The surgical steps and technical aspects of the procedure parallel those for a typical total ankle arthroplasty with the key difference being the preparation and implantation of a fresh two-part allograft consisting of the distal part of the tibia and the talar dome. This procedure is technically challenging and should not be considered by those with limited experience with ankle reconstruction.
Views: 236 JBJSmedia
Concomitant tibiotalar joint effusion and a partial tear of the talonavicular ligament at US.
 
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Dynamic sagittal 12-5 MHz US demonstrates concomitant tibiotalar joint effusion and a partial tear of the talonavicular ligament following ankle sprain. Tib= tibia. Tal= talus. Asterisk= tibiotalar joint effusion. Injuries to the dorsal talonavicular ligament are rare and occur following forced plantar flexion of the foot. They are typically depicted by target evaluation because of point tenderness over the talonavicular joint. In the acute setting, tibiotalar joint effusion is a common associated finding.
Views: 474 ShoulderUS.com
Talus Fracture Types - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim’s educational animated video describes fracture types of the Talus. Anatomy of the talus •Head •Neck •Body •Lateral process •Posterior process •Medial & lateral tubercle Posterior view of the ankle & hindfoot: Posterior process of the talus is made up of a smaller medial tubercle and a larger tibial tubercle that is separated by a groove for the flexor hallucis longus muscle. Fractures of the talus •Head fracture •Neck fracture •Body fracture •Lateral process fracture •Posterior process fracture •Osteochondral fracture The main blood supply of the talus is the artery of the tarsal canal. It comes from the posterior tibial artery and supplies the majority of the talar body. The deltoid branch from the posterior tibial artery is an important branch involving badly displaced fractures. It supplies the medial part of the talar body. Interruption of the blood supply causes death of the bone, AVN and nonunion. Head fracture: 5-10% of all talar fractures are head fractures. Neck fracture: the fracture line exits inferior surface anterior to the lateral process. There are four types of talar neck fractures. •Type I: non-displaced. 15% AVN •Type II: fracture with subtalar dislocation or subluxation. 50% AVN. •Type III: fracture with subtalar and tibiotalar dislocation. 90% AVN. •Type IV: fracture with subtalar and tibiotalar dislocation and talonavicular subluxation. 90-100% AVN. Body fracture The fracture line exists inferior surface behind the lateral process. 25% AVN & 25% AVN with subtalar dislocation. Lateral process fracture •CT scan is helpful for lateral process fractures. There are three types of lateral process fractures that are called “snowboarder’s injuries” . •Type I: avulsion •Type II: large fragment: especially involving the joint needs surgery. •Type III: comminuted. Small and comminuted fragments treated with a cast. Posterior process fracture •Rare injury •Usually missed on initial x-rays •Misdiagnosed as an ankle sprain •Mechanism of injury: usually forcible plantar flexion of the ankle (nutcracker injury). •Differential diagnosis: Os Trigonum. •Treatment: if fracture is missed, painful nonunion and instability of the subtalar joint may result. CT scan is helpful. Lateral view in 30 degrees external rotation may show the fracture. Larger fragment involving the joint requires surgery. Smaller fragment; immobilize in a cast or a boot. Osteochondral lesion: •Osteochondral lesions can occur in the talus. It may require surgical treatment. Can occur in severe trauma to the ankle or severe ankle sprain. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC
Views: 48683 nabil ebraheim
Osteopathic Maniputation of the Foot: Subtalar Joint HVT.mpg
 
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Osteopathic manipulation to the subtalar joint (heel) of the foot. Part of a series of educational videos from David Lintonbon DO at the Integrated Medical Centre 121 Crawford Street London W1U 6BE tel;07958488784 To purchase the entire DVD go to www.theartofhvt.com Pay by paypal and receive free postage worldwide
Views: 35123 David Lintonbon DO
Ankle Fusion Surgery Animation
 
01:45
Ankle Fusion Surgery Video. This video and other orthopaedic animations (in HD) are available for instant download licensing here: https://www.alilamedicalmedia.com/-/galleries/all-animations/bones-joints-and-muscles-videos Voice by: Sue Stern. ©Alila Medical Media. All rights reserved. Support us on Patreon and get FREE downloads and other great rewards: patreon.com/AlilaMedicalMedia All images/videos by Alila Medical Media are for information purposes ONLY and are NOT intended to replace professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition. Ankle arthrodesis, commonly known as “ankle fusion surgery”, is a reconstructive surgical procedure where the bones of a damaged ankle joint are fused into one single bone. This eliminates motion and reduces pain associated with movement of the joint. It is a highly successful procedure commonly suggested for repair of severely injured joints. During the procedure, the end of the fibula is cut to gain access to the joint. Damaged bones and cartilage are then removed. Screws, and possibly plates, are used to fix the tibia and talus together. With time, bone tissue grows fusing the joint into one solid mass of bone. Sometimes, bone graft may be added to facilitate bone growth. Bone graft is usually taken from some other bones of the same person. Screws and plates will remain inside the body after surgery. After the surgery, the up and down range of motion is mostly restricted, but lateral movement remains unchanged. The majority of people with ankle fusion do not limp. Compared to ankle joint replacement and other ankle procedures, ankle fusion has higher success rate, with less pain and less complication risk.
Views: 31677 Alila Medical Media
Movement After Ankle Fusion
 
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Movement After Ankle Fusion Visit http://www.davidgordonortho.co.uk/ for more information
Heel Up vs. Heel Down - A Perspective Using Anatomy
 
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A video detailing the movements of the tibiotalar (ankle) joint based on its anatomy in heel up and heel down technique. A must see for every drummer. I believe as drummers it is very important to understand the anatomical movements of our bodies so we can select the best technique for the music. This video provides a brief, simplified insight.
Views: 957 DrumLabTV
452 Foot Ankle Pathology Diagnosis Treatment
 
01:22:18
Presented by: Mary Lloyd Ireland Professor Dept. of Orthopaedic Surgery and Sports Medicine University of Kentucky Lexington KY www.marylloydireland.com 0:00 Introducdion 0:24 A good History and Physical is Key 0:39 Foot: Pronated Hand 0:58 Function •Propulsion •Support •Flexibility •Rigidity •Gait mechanics: ankle and foot motions 1:39 Ankle Axis 2:30 Ankle Axis: Opposite with foot fixed 3:38 Subtalar Joint 4:44 Windlass Mechanism 5:02 During gait: coupled motion between ankle and subtalar joints 8:08 Leg Movment 8:37 Ankle: Modified Hinge Joint 9:18 With complete history and physical and appropriate imaging, the diagnosis should be made and be specific 13:14 Summary of Findings From the National Collegiate Athletic Association 14:12 Basketball Injury Mechanism Video 14:47 EUA Gross instability, right ankle video 16:01 18 YO Female Gymnast •Right ankle injury •Landed awkwardly doing a back tuck •Immediate pain and swelling, right ankle 16:10 Initial X-rays 16:41 Stress tests, L & R ankles 17:12 Dx lateral talus fracture displaced 17:33 Physical Exam of the Foot and Ankle Video 18:32 Lateral Ankle Pain Soft Tissue 19:13 14 YO Female •Soccer athlete •Left ankle •Acute lateral talar dome fracture •Documented by plain films and bone •edema on MRI 19:16 Initial X-Rays 19:46 1 Month after Initial presentation 20:27 Talar Dome Fracture 20:45 Osteochondral Talar Lesions 21:11 Mechanism of injury of medial border of the dome of the talus. 22:08 Soft Tissue Lesion Location 24:32 Physical Exam of the Foot and Ankle Video 25:12 Think About Peroneal Tendon Involvement If: •Recurrent Ankle Complaints •Sprain Not Getting Better •Pain, Swelling Higher in Peroneal Tendon Sheath 25:37 In Acute Ankle Sprain, Assess Peroneal Function 25:58 17 YO WM High school Baseball/Football Player C/O Repeated Inversion Ankle Sprains 26:14 Peroneal Tendon Subluxing Video 27:42 Physical Exam of the Foot and Ankle Video 28:50 19 YO basketball player Os vesalianum bilateral feet. 29:20 Os peroneum 29:33 Medial Ankle Pain Differential Diagnosis 30:25 Posterior Tibial Tendon Dysfunction Stages 31:12 "Too Many Toes" Sign 34:16 18 YO Freshman Div. I basketball athlete 34:55 Navicular 37:06 Posterior Ankle Pain Differential Diagnosis 37:48 Bony Impingement of the Ankle Motion & Contact Areas 38:09 Anterior Tibiotalar Impingement Syndrome "Footballers" Ankle 38:32 FHL Tendinitis 39:19 Witherspoon MOI Video 40:27 Thompson Test Video 41:15 Achilles Tendon Video 43:20 Ankle Fracture Dislocations Video 44:40 Fractures Maisonneuve Fracture 48:46 Fracture blisters Leave alone. Do not lance unless they look infected. 49:33 Football athlete: Twists ankle on Astroturf Video 50:22 On-site Physical Treatment Video 52:38 Fractures Dislocation 53:19 Radiographs 54:08 14 YO Male •Left ankle •Tillaux fracture with displacement 54:44 Physical Exam Video 56:13 CT Scan 56:37 16 YO WM Basketball Athlete •Injury: Left Ankle •8 months prior to KSM visit •Continued ankle pain and swelling 56:55 Radiographs in ER post injury Casted for 3 months 57:35 2 weeks post injury 58:40 2 months post injury 59:13 Surgery – 9 months post injury 1:00:41 1 month post surgery 1:01:40 Don’t miss a Lisfranc midfoot fracture dislocation 1:02:56 Will require ORIF 1:03:43 Claw Toes Flex:ed PIPJ/DIPJ: Think Neurologic Involvement 1:04:29 Freiberg’s Infraction 1:05:16 Turf Toe: Football Athlete 1:05:56 Heel Pain 1:07:10 13 YO White Male •Right midfoot pain for 1 month •No specific injury •Baseball athlete •Rapid growth phase PE: •Tenderness over medial arch and midfoot •Stable normal ankle exam •Tenderness over posterior tibialis tendon 1:07:53 13 YO White MaleWorkup: •Plain xrays – negative •MRI scan – medial cuneiform stress fracture Treatment •Boot •Nonweightbearing 4 weeks •Full weightbearing 4 weeks •Improved •Cleared for return to baseball 1:08:26 Films in early summer 2009 1:09:44 Followup 1:10:08 RIGHT FOOT 1:10:29 RIGHT ANKLE 1:10:51 MRI Scan 1:11:29 Foot and Ankle Consult Recommended 1:12:19 1 Year Later 1:13:16 Diagnosis •Enthesistis Related Arthritis •HLAB 27 Positive •No clinical evidence of ankylosing spondylitis Treatment: •Medications: •Methotrexate, Naprosyn •Home Rehab program •Returned to baseball wearing AFO 1:14:41 15 YO Male •Right ankle •6 Months of Pain •Initial x-ray: 1:15:16 1 month followup 1:19:08 14 months post op 1:19:18 17 YO Male •Left ankle pain x3 weeks •Trying to get in shape, played more basketball than usual •Possible stress fracture of the medial malleolus 1:19:56 3 months after initial presentation 1:20:11 5 Months after initial presentation 1:20:53 7 months after initial presentation 1:21:13 Small Blue Cell Tumor 1:21:23 A good History and Physical is Key 1:22:07 Thank You
Views: 1932 UKyOrtho
Ankle Joint Injection (Cortisone Shot) MSK
 
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Pain management interventional procedure for Ankle arthritis.
Dislocations Of The Talus - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim’s educational animated video describes the Dislocation of the Talus Bone, which can be either Total or Subtalar, Subtalar could be Lateral or Medial. Dislocations of the talus can be a total dislocation or a subtalar dislocation. Types of dislocation Total dislocation of the talus which is not accompanied by a fracture is a very rare injury. Most of the injuries are open. Urgent care is necessary to avoid soft tissue complication. High risk of avascular necrosis of the talus, arthritis and soft tissue infection. Subtalar (the foot is lateral or medial ). Subtalar dislocation of the talus is a rare injury that results from excessive pronation. It involves simultaneous dislocation of the distal articulations of the talus at the talocalcaneal and talonavicular joints. Lateral subtalar dislocation/ tibialis posterior tendon entrapment It is often a result of high energy trauma. Worse long-term prognosis. Irreducible lateral dislocation due to interposed tibialis posterior tendon. Could be unstable and may sublux. May need CT scan to check for fractures. Medial subtalar dislocation 85% of the dislocations are medial and often result from low energy trauma. Irreducible medial dislocation due to interposed extensor digitorum brevis or extensor retinaculum. The direction of subtalar dislocation has important effects with respect to management and outcome. Complications of subtalar dislocation may include stiffness and subtalar arthritis. Treatment •Stable- closed reduction with 3-4 weeks of immobilization followed by physical therapy. •Unstable- after closed reduction internal fixation may be required. The anteromedial incision is used for medial dislocation. Lateral approach is used for lateral dislocation.
Views: 23714 nabil ebraheim
Mobilisation With Movement (MWM) of the Tibiotalar joint.
 
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Mobilisation With Movement (MWM) of the Tibiotalar joint to increase dorsiflexion by showing the correct movement. This is a modified technique due to patient having balance issues.
Views: 310 Dave Johnson
Ankle joint
 
00:27
Views: 2442 AshtonMoh
Ankle Ligament Tear Treatment
 
02:56
Chronic ankle sprains and talofibular ligament tears are commonly treated with Prolotherapy, a regenerative injection technique. In this video, Ross Hauser, MD discusses ankle ligament tears and treatment course. To learn more about Prolo and the types of chronic pain and injuries we treat, please visit us at: http://www.caringmedical.com/prolotherapy Thanks for watching! Contact our team to tell us more about your case and see if you are a good candidate for our treatments: http://www.caringmedical.com/contact-us/ Access our published research and articles on Regenerative Medicine: http://www.prolotherapy.org/ Find us on Social Media: Facebook: https://www.facebook.com/stemcellprolotherapy/ Instagram: https://www.instagram.com/explore/locations/1030271890/ Twitter: https://twitter.com/CaringMedical?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor Pinterest: https://www.pinterest.com/caringmedicalre/
Ankle Fractures & X Rays - Everything You Need To Know - Dr. Nabil Ebraheim
 
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Dr. Ebraheim’s educational animated video describes about fractures of the ankle X - rays, ankle fracture classification,ankle fracture dislocation, it also describes ankle fracture treatment and ankle fracture surgery and ankle fracture recovery. The Mortise view is about 15° of internal rotation. The medial clear space should be 4-5 mm or less, and it should be equal to the superior clear space which is between the talus and the distal tibia on the mortise view. If the medial clear space appears widened before surgery, then there is a deltoid injury. If the medial clear space does not appear widened, then make sure that you do not have a supination- external rotation type 4 injury. You may need to do stress view x-rays before surgery in order to prove that the deltoid ligament is or is not injured. The tiblofibular clear space should be less than 6 mm on the mortise view and it is the distance between the medial border of the fibula and the tibial Incisura notch. If the tiblofibular clear space is widened and the ankle mortise is unstable, this allows the talus to shift because the syndesmosis is unstable. 1 mm of talar shift will give a 42% decrease in tibiotalar contact area. This will cause future, accelerated arthritis. The tiblofibular overlap is about 10 mm in the AP view and you measure that from the medial border of the fibula. In the mortise view, the tibiofibular overlap should be more than 1 mm. Talo-Crural Angle I don’t use this and find not much value in this measurement except on exam questions! The lateral malleolus is longer than the medial malleolus, if the fibula is short, I can rely on two other x-ray measures that can help me: 1- Shenton’s Line: The subcondylar bone of the tibia and fibula should form a continuous line around the talus, so if the fibula is short then the spike of the fibula will too proximal. - If the fibula is long then the spike of the fibula will too distal. - Always look for the broken line from the lateral part of the articular surface of the talus to the distal fibula. 2- Dime Test - Look for the sprung mortise. - Look for the spike of the fibula to proximal. - Look for the broken Shenton’s Line. - Look for the Dime Test. - Look for medial clear space widening. - Get a lateral x-ray to see if there is a posterior malleolus fracture. - See if there is any talar subluxation. - See if there is any other associated Injuries from the talus and the calcaneous. The most important thing you will see on the lateral view x-ray of the ankle is the type of fracture: is it a Pronation - External rotation or Supination - External rotation Injury. - you will see that from the direction of the fracture. or Is the fracture comminuted? So you can say this is Pronation - Abduction Injury. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter: https://twitter.com/#!/DrEbraheim_UTMC Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund: https://www.utfoundation.org/foundation/home/Give_Online.aspx?sig=29
Views: 20547 nabil ebraheim
tibiotalar joint effusion treatment
 
03:21
http://vivaint.biz/net/azol FO FREE! It seems you can hardly get through your day without something hurting. Finally, there's a natural solution to those annoying aches and pains with Eazol. Order your free trial today! Limited supp;y! Hurry up!
Views: 161 How to cure joints.
452 Gait Analysis and Differential Diagnosis
 
44:17
Presented by: Mary Lloyd Ireland Professor Dept. of Orthopaedic Surgery and Sports Medicine University of Kentucky Lexington KY www.marylloydireland.com 0:00 Introducdion 0:24 A good History and Physical is Key 0:39 Foot: Pronated Hand 0:58 Function •Propulsion •Support •Flexibility •Rigidity •Gait mechanics: ankle and foot motions 1:39 Ankle Axis •Thus, with leg fixed and foot free •Dorsiflexion results in outward deviation of the foot •Plantarflexion results in inward deviation 2:30 Ankle Axis: Opposite with foot fixed •With foot fixed, dorsiflexion / Plantarflexion results in rotation of the leg •Dorsiflexion results in internal rotation •Plantarflexion results in external rotation 3:38 Subtalar Joint •Eversion and inversion of the subtalar joint are directly tied to internal and external rotation of the tibia 4:44 Windlass Mechanism •Dorsiflexion of the proximal phalanges pulls the plantar aponeurosis over the metatarsal heads, resulting in depression of the metatarsal head and elevation of the longitudinal arch 5:02 During gait: coupled motion between ankle and subtalar joints •First •Tibial internal rotation •Talar eversion •Foot pronation •Third •Tibial external rotation •Talar inversion •Foot supination 8:08 Leg Movment 8:37 Ankle: Modified Hinge Joint Bony configuration •Mortise •Circular Pretzel Ligamentous stability •ATF and CF laterally •Deltoid superficial and deep medially •Syndesmosis superiorly 9:18 With complete history and physical and appropriate imaging, the diagnosis should be made and be specific.9:34 Lateral Ankle Pain •Sprain ATF and/or CF •Sinus Tarsi Syndrome •Subtalar Joint •Arthrosis Fracture •Cuboid Subluxation •Peroneal Dysfunction 13:14 Summary of Findings From the National Collegiate Athletic Association Injury Surveillance System on Foot and Ankle Injury. 14:12 Basketball Injury Mechanism Video 14:47 EUA Gross instability, right ankle video 16:01 18 YO Female Gymnast •Right ankle injury •Landed awkwardly doing a back tuck •Immediate pain and swelling, right ankle 16:10 Initial X-rays 16:41 Stress tests, L & R ankles 17:12 Dx lateral talus fracture displaced 17:33 Physical Exam of the Foot and Ankle Video 18:32 Lateral Ankle Pain Soft Tissue Soft Tissue Mass •Ganglion Meniscoid of the Ankle •Tomansen, Denmark 1982 Scar + Synovitis Gutter •Ferkel’s Phenomenon, AJSM 1991 Distal Slip Anterior Tibiofibular Ligament •Bassett’s Ligament, JBJS, 1990 19:13 14 YO Female •Soccer athlete •Left ankle •Acute lateral talar dome fracture •Documented by plain films and bone •edema on MRI 19:16 Initial X-Rays 19:46 1 Month after Initial presentation 20:27 Talar Dome Fracture 20:45 Osteochondral Talar Lesions Osteochondritis Dissecans •Men 3 : 1 Women •Medial : Lateral •2 : 1 Etiologies •Trauma •Vascular •Repetitive Loading 21:11 Mechanism of injury of medial border of the dome of the talus. •Berndt, A.L. and Harty, M.: “Transchondral fractures of the talus” – JBJS 41 –A:988, 1959 22:08 Soft Tissue Lesion Location •Ankle •Anterolateral •ATF or CF Sprain •Peroneal Tendinitis •Posteromedial •PT or FHL Tendinitis •Deltoid Sprain 24:32 Physical Exam of the Foot and Ankle Video 25:12 Think About Peroneal Tendon Involvement If: •Recurrent Ankle Complaints •Sprain Not Getting Better •Pain, Swelling Higher in Peroneal Tendon Sheath 25:37 In Acute Ankle Sprain, Assess Peroneal Function 25:58 17 YO WM High school Baseball/Football Player C/O Repeated Inversion Ankle Sprains 26:14 Peroneal Tendon Subluxing Video 27:42 Physical Exam of the Foot and Ankle Video 28:50 19 YO basketball player Os vesalianum bilateral feet. 29:20 Os peroneum 29:33 Medial Ankle Pain Differential Diagnosis •Deltoid Sprain •Medial Malleolus Fracture •Tendinitis •Posterior Tibialis •Flexor Hallucis Longus •Osteochondral •Talus Fracture •Osteochondritis Dissecans 30:25 Posterior Tibial Tendon Dysfunction Stages 31:12 "Too Many Toes" Sign 34:16 18 YO Freshman Div. I basketball athlete •C/O mid-foot pain, L greather than R •Started when she was running, playing in shoes mandated by her school •History of “normal” periods 34:55 Navicular •Initial x-rays 37:06 Posterior Ankle Pain Differential Diagnosis •FHL Tendinitis •Posterior Process Talus Fracture (Shepherds 1982) •Posterior Impingement •Os Trigonum •Achilles Tendon •Overuse •Tear, partial vs. complete 37:48 Bony Impingement of the Ankle Motion & Contact Areas 38:09 Anterior Tibiotalar Impingement Syndrome "Footballers" Ankle 38:32 FHL Tendinitis •“Dancers” Tendinitis 39:19 Witherspoon MOI Video 40:27 Thompson Test Video 41:15 Achilles Tendon Video 43:22 A good History and Physical is Key 44:05 Thank You
Views: 375 UKyOrtho

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