Joints of the foot.pptx Gross anatomy of the lower limb

Joints of the foot

1. Joints of the foot

2. talocalcaneal Plane synovial Consists of ant and post articulations Subtalar joint – clinical and functional definitions vs anatomical definitions Surfaces Concave posterior calcaneal facet on talus Convex posterior facet on superior surface of calcaneus Capsule – short fibres attached to articular margins

3. Ligaments talocalcaneal Lateral – short and flat. Descends obliquely from lateral talar process to lateral calcaneal surface Medial – medial talar process to the back of sustentaculum tali and medial surface of calcaneus Interosseous – broad flat bilaminar band. Runs in sinus tarsi. Posterior lamina associated with talocalcaneal joint, anterior lamina with talocalcaneonavicular joint. Medial fibres taut in eversion Posterior/cervical ?? – lateral to the sinus tarsi

4. Synovial cavity – does not communicate with any other joints. Rarely with ankle joint Innervation – tibial, medial plantar and sural nerves Stability – bony contour Talocalcaneal ligaments Calcaneofibular ligament

5. Actions Inversion – plantar aspect of foot faces medially TA, TP, triceps surae , long toe flexors Eversion – plantar aspect of foo faces laterally PL, PB, PT, long toe dorsiflexors

6. talocalcaneonavicular Compund multiaxial synovial joint Surfaces Talar head Anterior facets of inferior surface of talar head Concavity of posterior surface of the navicular Middle and anterior facets on upper surface of calcaneus Superior surface of plantar calcaneonavicular ligament

7. Capsule – poorly developed. Thick posteriorly and blends with interosseous ligament, anterior lamina Ligaments Talonavicular – broad and thin. Connects dorsal surfaces of talar neck to that of the navicular Calcaneonavicular – part of bifurcate ligament

8. Plantar calcaneonavicular ligament Also called spring ligament Broad thick band Connects anterior margin of sustentaculum tali to plantar surface of navicular Sustains medial longitudinal arch of the foot Dorsal aspect has a fibrocartilaginous facet for resting of talar head

9. Innervation – deep fibular and medial plantar nerves Stability – bony contours and spring ligament Movements – inversion and eversion

10. calcaneocuboid Lateral part of transverse tarsal joint Separates hindfoot from midfoot Found 2cm proximal to the base of 5 th metatarsal tubercle Plane synovial Surfaces – anterior surface of calaneus and posterior surface of cuboid Thin capsule reinforced dorsally Synovial cavity does not normally communicate with any other

11. ligaments Bifurcate ligament – strong Y shaped band. Attached proximally to the calcaneus and divides distally into calacaneocuboid and calcaneonavicular parts Long plantar ligament – longest ligament of the tarsus. From tuberosity of calcaneus to the tuberosity of the cuboid. Superficial fibres extend to the bases of second to 5 th metatarsals. Forms a tunnel for fibularis longus. Strongest support for lateral longitudinal arch

12. Plantar calcaneocuboid – also called short plantar ligament. Deep to long plantar ligament. Runs from anterior tubercle of calcaneus to adjacent surface of cuboid. Strong support for the lateral longitudinal arch

13. Innervation – lateral plantar nerve, sural and deep fibular nerves Movements – gliding movements occur in conjunction with the inversion/eversion occurring at the subtalar joint complex

14. cuneonavicular Navicular distal convex surface divided into 3 facets by low ridges Capsule – continuous with those of the intercuneiform and cuneocuboid joints Ligaments Dorsal and plantar – slips are given off the navicular to each of the cuneiform bones Innervation – deep fibular, medial and lateral plantar

15. Movements are slight gliding associated with pronation and supination of the foot

16. Intercuneiform and cuboidocuneiform All synovial plane joints Ligaments Dorsal and plantar ligaments connecting adjacent bones Interosseous ligaments connecting non articular parts of adjacent bones Innervation – medial and lateral plantar nerves

17. Tarsometatarsal Surfaces – between the cuneiforms and cuboid proximally and the bases of the 5 metatarsals distally Capsule – that of the hallux has its own capsule. The rest communicate with each other and with the intercuneiform and naviculocuneiform joints Ligaments – plantar, dorsal and interosseous

18. Movements greatly limited but some flexion and extension occur. At the hallux TMT joint some abduction and rotation do occur Innervation – deep fibular nerve, medial and lateral plantar nerves

19. Intermetatarsal Joined by interosseous as well as dorsal and plantar ligaments. They are each irregular, transverse, longitudinal and oblique

20. metatarsophalangeal Synovial condylloid joints Between metatarsal heads and bases of the proximal phalanges Head of first metatarsal also articulates with 2 sesamoid bones found in the tendon of flexor hallucis brevis Ligaments – plantar, deep transverse metatarsal and collateral Movements – flexion, extension, abduction, adduction

21. Interphalangeal Synovial hinge joints Each has an articular capsule, synovial membrane and 2 collateral ligaments. Capsule is thickened on its plantar aspect and may constitute a plantar ligament Movements – flexion and extension. Abd and add- ction greatly limited