• origin- calcaneal tuberosity, medial process
• insertion- through med. sesamoid to prox phalanx of great toe
• innervation- med. plantar N.
• action- abduct great toe

• origin- calcaneal tuberosity, med. process
• insertion- sides of middle phalanges
• innervatoin- med. plantar N.
• action- flex lat. four toes

• origin- calcaneal tuberosity, med. and lat. processes
• insertion- lat. base of prox phalanx (5th toe)
• innervation- first branch of lat. plantar N.
• action- abduct small toe

Nerve can be entrapped by abductor hallucis fascia

• origin- med. and lat. plantar calcaneus
• insertion- lat FDL tendon
• innervation- lat. plantar N.
• action- assist FDL w/toe flexion

• origin- separate FDL tendons
• insertion- prox phalanges, extensor expansion
• innervation
• 1st- med. plantar N.
• 2-4- lat. plantar N.
• action- flex MTP joint, extend IP joint

• origin- cuboid, lat. cuneiform
• insertion- through sesamoids to prox. phalanx of great toe
• innervation- med. plantar N.
• action- assist great toe flexxion at MTPJ

• origin
• oblique- base 2-4 MT
• transverse- lat. 4 MTP
• insertion- through lat sesamoid to lat. prox phalanx of great toe
• innervation- lat. plantar N.
• action- adduct great toe

contribute to hallux valgus deformity

• origin- base of 5th MT
• insertion- base of prox phalanx of small toe
• innervatoin- lat. plantar N.
• action- flex small toe

• origin- med. 3rd, 4th, and 5th MT's
• insertion- med. proximal phalanges (toes 3-5)
• innervation- lat. plantar N.
• action- adduct toes, flex at MTPJ, extend at LPJ

• origin- adjacent MT shafts (4)
• insertion
• med.- prox phalanx of 2nd toe
• lat.- prox phalanx of toes 2-4)
• innervation- lat. plantar N.
• action- abduct toes

bipennate muscle

• origin- dorsolat. calcaneus
• insertion- base of prox phalanx of great toe
• innervation- deep peroneal N.
• action- extend great toe at MCPJ

• origin- dorsolat. calcaneus
• insertion- base of prox phalanx toes 2-4
• innervatoin- deep peroneal N.\
• action- extend lesser toes at MCPJ

• artery of tarsal canal (branch of post. tibial)
• deltoid artery (branch of artery of tarsal canal)
• direct superomedial arteries (branch of dorsalis pedis)
• artery of tarsal sinus (branch of dorsalis pedis and/or perforating branch of peroneal A.)
• direct post. arteries (branch of perforating branch of peroneal A.)

• AP with 15 degrees internal rotation
• used to view widening of spaces (ligamentous injuries)

• mortise with external stress
• evaluate for syndesmotic injury or ligament injury

• dorsiflex foot, beam 45 degrees to heel
• use- evaluate for calcaneal fx

• 15 degrees foot eversion, tilt beam 15 degrees
• use- talar neck fx

• central band
• medial band- support adbductor hallucis
• lateral band- supports abductor digiti minimi muscles (can be cause of avulsion fx)

• lateral
• ATFL
• CFL
• PTFL
• medial
• deltoid ligament
• superficial- ant. tibotalar, tibionavicular, tibiocalcaneal
• deep- post. tibotalar

• deep to peroneal tendons
• resists inversion

• mechansim- eccentric load
• PE: positive Thompson test
• tx- surgical repair, casting in equinus 

• tearing of the Lisfranc ligament (between 2nd MT and medial cuneiform
• mechanism- rotational force/torque w/an axial load on a hyperplantarflexed ankle
• XR- "Fleck sign", >2 mm distance btw base of 2nd MT and medial cuneiform
• complications- posttraumatic OA

• AITFL
• PITFL
• transverse tibiofibular ligament
• interosseous ligament

• ATFL
  • lateral malleolus to talus anteriorly 
  • limits inversion in plantarflexion
• calcaneofibular
  • lateral malleolus to calcaneus posteriorly 
  • limits inversion in neutral or DF
• PTFL
  • lateral malleolus to talus posteriorly
  • limits posterior talar displacement and external rotation

• tibionavicular
  • medial malleolus to navicular tuberosity
  • limits talus external rotation
• tibocalcaneal
  • medial malleolus to sustentaculum tali
  • limits hindfoot eversion
• anterior tibiotalar
  • medial malleolus to medial surface of talus
  • limits lateral displacement of talus, ext rot
• posterior tibiotalar
  • medial malleolus to insie of talus
  • limits lateral displacement

[image]

Ligament attaching to area