The ankle is one of the most vulnerable joints in the human body. Its damage often leads to complete immobilization of the person. It provides the connection of the foot with the shin. For normal walking it is necessary that he is healthy and fully fulfills his functions.
Ankle joint provides any movement of the foot. Anatomy of the ankle is quite complicated. It consists of several bones that are connected by cartilaginous formations and muscular ligaments.
Anatomical features of
The distribution of the pressure of the body weight of the person on the surface of the foot is provided by a nominal ankle, which is loaded with the entire weight of a person. The upper anatomic border of the ankle passes along the conventional line 7-8 cm above the medial malleolus( visible protrusion from the inside).The border between the foot and the joint is the line between the lateral and medial malleoluses. The lateral ankle is located on the opposite side of the medial malleolus.
The joint is divided into the inner, outer, anterior and posterior parts. The back of the foot is the front section. In the Achilles tendon region is the posterior section. In the medial and lateral ankle - internal and external sections, respectively.
Bones of the joint
Ankle joint connects the fibular and tibia with the supratenal bone - the talant or the bone of the foot. The appendage of the foot bone enters the nidus between the lower ends of the peroneal and tibial bones. An ankle joint is formed around this joint. In this basis, several elements are distinguished:
- inner ankle is the lower( distal) edge of the tibia;
- external ankle - the edge of the fibula;
- distal surface of the tibia.
The outer ankle behind has a recess in which tendons are fixed, which fit the muscles of the peroneal muscles - long and short. Fascia( connective tissue envelopes), together with lateral articular ligaments, are attached to the outer side of the external ankle. Fascia formed from protective cases that cover tendons, vessels, nerve fibers.
The ankle has a so-called cleft that is formed on its inner surface by the upper side of the talus and the hyaline cartilage.
Appearance of ankle
The structure of the ankle joint is easy to imagine. The surface of the lower edge of the tibia looks like an arc. The inner side of this arc has an outgrowth. Bottom on the tibia there are appendages in front and behind. They are called the anterior and posterior ankles. The tibia is on the outside of the tibia. On each side of this notch there are tubercles. The outer ankle is partially located in the peroneal incision. She and the peroneal incision together create an anteral syndrome. For the full functioning of the joint, its healthy state is very important.
The tibia has a distal epiphysis, which is divided into two unequal portions of the
. The anterior part is smaller than the posterior. The surface of the joint is divided into the inner and outer by the bone crest.
The anterior and posterior tubercles of the articular surface form the inner ankle. They are separated from one another by a fossa. The anterior tubercle is larger than the posterior. The deltoid ligament and fascia are attached to the ankle from the inside without articular surfaces. The opposite surface( on the outside) is covered with cartilage.
The calcaneus and the bones of the lower leg are connected by a talus bone, consisting of a head, neck, block and body. The block of the talus provides a connection with the shin. Between the distal parts of the peroneal and tibial bones a "fork" is formed, in which the talus bone block is located. The block is convex on the upper side, along it there is a depression, into which the crest of the distal epiphysis of the tibia enters.
The front of the unit is slightly wider. This part goes into the neck and head. On the back there is a small tubercle with a furrow, through which the flexor of the thumb passes.
The muscles behind the ankle joint provide flexion of the foot. These include:
- long flexors of toes;
- posterior tibial;
- triceps musculature.
In the anterior ankle are the muscles that provide extension:
- anterior tibial;
- extensors of toes.
Short long and third fibula are muscles that provide ankle movement in the outer direction( pronators).Movement inside provides supinators - a long extensor of the big toe and an anterior tibial muscle.
Normal functioning and movement in the joint is provided with the help of ligaments, which also hold the bone elements of the joint in their places. The most powerful ligament of the ankle is deltoid. It provides the connection of the talus, heel and scaphoid bones( feet) with the inner ankle.
Pelvic fibular ligament, as well as posterior and anterior talon-fibular are the ligaments of the outer part of the
. A powerful formation is the ligamentous apparatus of interdental syndesmosis. The tibia are held together, thanks to the interosseous ligament, which is the continuation of the interosseous membrane. The interosseous ligament passes into the posterior lower ligament, which keeps the joint from turning too far inwards. The front lower interbody coil restrains from too much turning in the outward direction. It is located between the peroneal incision, which is located on the surface of the tibia and the outer ankle. In addition to the excessive rotation of the foot, the transverse ligament, located under the intercellular ligament, is kept outward.
The tissue supply is provided by the peroneal, anterior and posterior tibial arteries. In the area of the joint capsule, ankles and ligaments from these arteries, the vasculature diverges, since the arteries branch.
The outflow of venous blood occurs through the outer and inner networks that converge in the front and posterior tibial veins, the small and large subcutaneous veins. The venous vessels are connected in a single network by anastomoses.
The ankle can perform movements around its axis and along the axis passing through the point in front of the external ankle. The own axis passes through the center of the inner axis. On these axes, the motion is possible in an amplitude of 60-90 degrees.
Often the ankle is injured, nerve endings and muscles can be damaged, ankle fractures occur, fractures, ligament tears and muscle fibers, fractures or cracks in the tibia
How does the ankle pain manifest?
If you have pain in the ankle, it is usually difficult for a person to walk. Ankles become swollen, blue skin may appear in the affected area. It is almost impossible to step on the foot due to a significant increase in pain in the ankle, which loses its ability to withstand the weight of a person.
If the ankle is affected, the pain can be irradiated to the knee or shin area. The majority of athletes are at the risk of having pain in the ankle joint, as when playing soccer, tennis, volleyball, hockey and other mobile sports on the joints of the feet, there is a significant load.
There are several most common injuries that cause pain in the ankle area. These include injuries - dislocations, subluxations, fractures, etc. The ankle is one of the most prone to injury to the joints. Every person knows an unpleasant feeling that occurs when you tuck your leg.
Ankle is an area that undergoes fractures more often than most bones in the human body. The fracture is usually provoked by a sharp and overly rapid movement of the ankle inward or outward. Often a fracture of the ankle is accompanied by an extension of the ligaments of the ankle joint. Fractures and other injuries of the ankle are more susceptible to people who have ligaments weak. With ankle injuries, the joint area swells, the strongest pain does not allow it to stand on its foot.
Tarsal Tunnel Syndrome
This pathology is a neuropathy associated with damage to the posterior tibial nerve. The nerve shrinks, as if passing through a tunnel. In this case, the person feels the tingling and soreness of the ankle joint. These same feelings can spread to the feet. In the area of the ankle and in the legs, cold or fever may be felt.
This disease causes inflammation of the Achilles tendon. Tendonitis often causes complications in the form of a rupture of the tendon or arthritis. If you experience pain during running or walking, a swelling in the ankle and pain in it, you might suspect Achilles tendonitis. You can not run his treatment, as this is fraught with often recurring injuries, especially for people who often walk a lot, run, jump.
Arthritis of the ankle
Arthritis is the most common ankle disease. Depending on the type of arthritis, the causes that caused it may be different, but the most frequent and common are:
- Infection of the joint with pathogenic bacteria. These can be gonococci, chlamydia, pale spirochetes. In this case we are talking about a specific form of the disease. Nonspecific form occurs as a secondary disease after the flu or furunculosis.
- Gout. Because of a metabolic disorder in the body, the ankle joint may be affected.
- Immune system disorders. The organism can recognize the cells of the joint tissues as alien and begin an attack on them.
- Injuries and mechanical injuries.
Factors that trigger the development of the disease can be the following:
- wearing uncomfortable shoes;
- flat feet;
- hormonal disorders;
- disruptions in metabolism;
- strong professional load( mainly among athletes);
- strong supercooling;
- excess weight;
- hereditary predisposition;
- unhealthy lifestyle;
- allergy and decreased immunity.
Treatment of arthritis is performed conservatively or surgically. When bacterial form of the disease requires antibacterial therapy. It is important to follow a special diet to reduce pain and reduce the manifestations of the disease. It is necessary to exclude from the diet nightshade, canned food and smoked meat, the use of salt should be minimized. For the removal of inflammation, NSAIDs are prescribed( Diclofenac, Voltaren, Aspirin).Help the patient to help the painkillers. To improve metabolism, additional removal of inflammation and early recovery of cartilage tissue is recommended to take vitamins and dietary supplements.
The joint is recommended to immobilize and completely give up loads on it, for walking it is necessary to use crutches
Complications of incorrect or untimely treatment of arthritis can become deforming arthrosis or synovitis. In this case, often enough patients need surgery, as a result of which it is possible to restore the mobility of the joint.
After the arthritis of an ankle joint, patients are recommended hydromassage, warming and therapeutic baths. These procedures help to speed up the restoration of the joint and prevent a relapse of the disease.
Significant burden on the ankle joint provokes its frequent pathologies. Preventing disease can be, adhering to a healthy diet, abandoning bad habits and avoiding excessive stress.