Ankle joint

The ankle - bokoviny joint is formed articular surfaces of the distal ends of the big and small Shin bone and articular surface of the block talus. Both bone at the bottom are connected by ligaments and form the plug covering the top and side of the body talus. Articular surfaces of the bones covered with hyaline cartilage. Joint bag fortified strong ligaments (see Fig. 1).

Fig. 1. Ligaments and joints of the right foot (front): 1 - a big tibia; 2 - inner ankle; 3 - ankle (opened); 4 - the deltoid ligament; 5 - the talus; b - heel-peroneal link; 7 - outer ankle; 8 - the front malomernogo-ankle ligament.

Ankle region has a distinctive contours. Front ankle bend are issued through the skin, tendons extensor of the fingers and the anterior tibial muscle, behind - the serious Achilles tendon, on the sides - the medial and lateral malleolus.
Supplied ankle blood from the anterior and posterior tibial artery. Ripple first of them is determined on the front surface of the foot and ankle, and the second one behind the inner ankle. The skin on the front surface of the ankle joint and around the ankles directly adjacent to the bone.
Movements in the ankle joint occur mainly in two directions: in a bottom - bend and in the back - extension. The amplitude of these movements in adults reaches 60 - 70 degrees.
From the injuries of the ankle joint can be injury (see), distortion (see) and tear ligaments, fractures ankles, combined with fractures of the lower back or the front edge of the tibia with a break lower tibiofibular connection.
Fibula fracture on 6-8 cm above the top of the outer ankle in combination with internal fracture ankle called fracture Dupuytren (Fig. 2). Alike fracture Pott, in which the line fibula fracture takes place at the level of the joint space ankle.fracture Dupuytren
Fig. 2. Fracture of Dupuytren (scheme radiographs): 1 - before the reduction; 2 - after reset.

There are fractures of the ankles with subluxation feet outwards, combined with subluxation of the spine, at least - ankles-shift and subluxation foot inwards (fractures Malgina). In the ankle joint is observed isolated and combined fractures and dislocations fractures talus. Broken ankle without displacement of bone fragments and dislocation of the foot to diagnose harder than the fracture with displacement as swelling, bruising and pain in the ankle joint can be small and deformation be missing. At the slightest suspicion on a fracture, you need to make an x-ray of the foot and ankle in two projections.
First aid at fracture of the ankle - immobilization by means of the bus Kramer. In this situation the patient is transported to the hospital. Fractures, Pereloma-dislocations in the ankle joint require urgent reduction in hospital under local intraosseous anesthesia or General anesthesia; after the reduction is applied a plaster bandage. If you cannot set fragments and subluxations, showing surgery.
Open fracture of the ankle joint in peacetime are relatively rare. Gunshot fracture of the ankle joint is observed frequently in time of war.
First aid for open and gunshot injuries of the ankle joint is imposing an aseptic bandage and transport immobilization. In the hospital impose anti-tetanus serum (3000 AE on Besedke), penicillin, make primary processing wounds, reposition of fragments and put a plaster cast.
There are also inflammatory diseases of the ankle joint traumatic and infectious origin (TB), rheumatoid arthritis, arthrosis, and others (see Arthritis, Tuberculosis of bones and joints).
Cm. also the Joints.