Foot & ankle anatomy By: Fatemeh Javadi

Bones Calcaneus: forms the heel calcaneal tuberosity upper surface has articular facets for the talus anterior end articulates with the cuboid bone. sustentaculum tali Tarsal sinus

Talus rests on the superior surface of the calcaneus upper part of the articular surface articulates with the end of the tibia medial part, with the medial malleolus of the tibia lateral part, with the lateral malleolus of the fibula anterior end articulates with the navicular bone and inferiorly with the calcaneus

Navicular The navicular lies anterior to the talus on the medial side of the foot. It has a proximal articular surface for the head of the talus and a distal articular surface for the three cuneiform bones. Its lateral surface is attached to the cuboid

cuneiforms medial, intermediate, and lateral Their proximal ends articulate with the navicular through a synovial joint lateral cuneiform articulates with the cuboid

cuboid The cuboid has a proximal articular surface for the calcaneus distal one for the two lateral metatarsals small medial one for the lateral cuneiform

Metatarsals and phalanges bases of the metatarsals articulate with each other and with the cuneiform and cuboid bones their heads articulate with the bases of the proximal phalanges There are often two sesamoid bones at the metatarsophalangeal joint of the big toe.

Ankle Joint Hinge-type joint; distal ends of the tibia and fibula + Talus Medial (deltoid) ligament: ant & post tibiotalar, tibiocalcaneal, and tibionavicular. Resists eversion of foot. Lateral ligament: ant talofibular ligament, post talofibular ligament, and calcaneofibular ligament. Check inversion of the foot.

Joints of foot Intertarsal joints; subtalar, talocalcaneonavicular, calcaneocuboid, cuneonavicular, transverse tarsal (chopart’s joint) Tarsometatarsal joint Lisfranc joint Intermetatarsal joints Metatarsophalangeal joints Interphalangeal joints

Foot ligaments plantar calcaneonavicular ligament: resisting downward movement of the head of the talus, helps support the highest part of the arch long plantar ligament: supports lateral part of the arch

Talocalcaneal interosseous ligament

SUPERFICIAL NERVES cutaneous innervation of the sole of the foot is through branches of the medial and lateral plantar nerves. medial plantar nerve: branches to the medial side of the sole of the foot and three and a half toes. The lateral plantar nerve lateral side of the plantar surface of the foot and to the lateral one and a half toes.

skin on the medial side of the foot is innervated by the saphenous nerve skin on the lateral border of the foot is supplied by the sural nerve. skin of the dorsum of the foot is innervated mostly by superficial fibular nerve adjacent sides of the first and second toes are innervated by the deep fibular nerve.

The dorsum of the foot. A, interphalangeal joint; B, distal interphalangeal joint (note transverse skin crease); C, proximal interphalangeal joint; D, toenail; E, lunula; F, first meratarsophalangeal joint; G, fifth metatarsal; H , first metatarsal-cuneiform joint; I, dorsalis pedis artery; J, navicular; K, medial cuneiform; L, typical site of second metatarsal stress fracture; M, typical site of Jones fracture

Prominence of extensor tendons of toes increased by active extension. A, extensor hallucis longus; landmark for dorsalis pedis artery B, extensor digitorum longus to fifth toe

Anterior aspect of the ankle joint. A, medial malleolus; B, lateral malleolus; C, tibialis anterior tendon: dorsiflex D, extensor hallucis longus; lat to ant.tibialis tendon E, extensor digitorum longus; F, anterior inferior tibiofibular ligament; G, peroneus tertius.

Lateral aspect of the foot and ankle. A, base of the fifth metatarsal; B,lateral malleolus; C, sinus tarsae; D, extensor digitorum brevis; E, peroneus brevis tendon; F, Achilles'tendon; G, sural nerve; H, typical site of fibular stress fracture I; anterior talofibular ligament J, calcaneofibular ligament K, peroneal tubercle L, tuberosity of the calcaneus; M, anterior process of the calcaneus N,cuboid O, subcutaneous bursa

Posterior aspect of the foot and ankle. A,plantar fat pad B, calcaneai tuberosity; C, Achilles'tendon; D, soleus; E,sural nerve; F, medial malleolus; G, lateral malleolus.

Medial aspect of the foot and ankle. A , medial longitudinal arch B ,head of the first metatarsal; C, calcaneal tuberositv; D, medial malleolus; E, navicular tuberosity; F,saphenous vein G, post tibial tendon; inversion & plantar flex H, flexor digitorum longus tendon I, posterior tibial artery; J typical site of stress fracture of the medial malleolus; K, deltoid ligament.

Everting the foot increases the prominence of the peroneal tendons.

Plantar aspect of the foot' A, medial sesamoid; B, lateral sesamoid; C, typical site of plantar fasciitis; D‘ plantar fat pad of the heel.

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