Tuesday, November 28, 2023

Bones Of Ankle And Foot

Understanding Bone Spurs On Top Of Foot: Causes And Treatments

Ankle Fusion Surgery Animation

Bony outgrowths that form on the foots bones are referred to as bone spurs or osteophytes. These growths may be uncomfortable to walk or stand on and might be unpleasant. Bone spurs on top of foot, in particular, may cause discomfort in the toes, ball of the foot, and heel. The causes and available treatments for bone bump on top of footwill be covered in this article.

Clinical Relevance Potts Fracture

A Potts fracture is a term used to describe a bimalleolar or trimalleolar fracture.

This type of injury is produced by forced eversion of the foot. It occurs in a series of stages:

  • Forced eversion pulls on the medial ligaments, producing an avulsion fracture of the medial malleolus.
  • The talus moves laterally, breaking off the lateral malleolus.
  • The tibia is then forced anteriorly, shearing off the distal and posterior part against the talus.

Fig 5 Bimalleolar fracture of the ankle. 1 Fibula, 2 Tibia.

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Heel Spurs And Plantar Fasciitis

Heel spurs are bony growths that develop on the heel bone, or calcaneus. Although they may cause some discomfort, they are rarely painful.

However, heel spurs often develop as a result of a condition called plantar fasciitis, which can cause pain.

Plantar fasciitis refers to inflammation and thickening of the plantar fascia, which is the ligament that supports the arch of the foot.

The following factors can increase the risk of developing plantar fasciitis:

  • tight calf muscles that reduce the footâs ability to flex upward
  • a very high arch in the foot
  • repetitive impact from some sports

Plantar fasciitis can cause pain in the heel or bottom of the foot when standing or walking.

People who develop heel spurs without plantar fasciitis are unlikely to experience painful symptoms.

Heel spurs affect up to one in 10 people. Of these, only half will experience any pain.

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Changes In The Shape Of Your Arch

The arch is the inside mid-section of your foot. It determines how your bodyweight is spread and carried by the bones and joints of your feet.

For your foot to function at its best the arch should form a smooth arc from the ball of the foot to the heel.

The height of your arch may never cause you any kind of problems. Some people are born with arches that are higher or lower than average and their bodies adapt to them.

Other people may find their arch shape alters because of complications such as arthritis, weight, pregnancy, or injury. These changes can make you more likely to develop further problems in other parts of your foot, ankle, knee, hip and back.

If you are in pain and think your arch shape has changed speak to a healthcare professional about treatments. Insoles or supports made specially for your foot shape by an orthotist could improve pain caused by high or low arches.

S Of The Ankle: Which Ligaments Make Up The Ankle Joint

Ankle Fractures Broken Ankle

Along with the ankle bone anatomy, multiple ligaments surround both the ankle and Subtalar joints, which bind the bones of the leg to each other along with binding them to the bones of the foot. The Tibia and Fibula are connected by the Tibiofibular ligaments. This connection forms in the shape of a bracket and is covered in Hyaline cartilage. Hyaline cartilage is easily identifiable, known for its glass like appearance. It is pearly with a blue-gray tint in color and is slightly opaque.

Originating from the lateral Malleolus, the Lateral Ligament helps resist over-inversion of the foot. The Lateral Ligament consists of three separate ligaments:

  • Anterior Talofibular: Between the Lateral Malleolus and the lateral aspect of the Talus
  • Posterior Talofibular: Between the Lateral Malleolus and the posterior aspect of the Talus
  • Calcaneofibular: Between the Lateral Malleolus and the Calcaneus.

The Deltoid Ligament, or Medial Ligament, originates from the medial part of the distal Tibia and connects to the Medical Malleolus. The Medial Ligament consists of four ligaments which originate from the Malleolus and fan out to attach to the Talus, Calcaneus, and Navicular Bones. The Medial Ligament resists over-eversion of the foot.

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Other Causes Of Foot Pain

Pain in the foot can be a consequence of damage, pressure or rubbing over a long period of time.

Wearing badly fitting shoes, pregnancy, injury, or putting too much strain through specific parts of your foot can all cause changes in the shape of your feet. Often, these changes are painful and can affect your ability to do things.

Sometimes, its our choice of shoes that has the biggest impact on the structure of our feet and the problems we develop, such as:


Corns are raised areas of hard, knobbly skin which develop where calluses have been left untreated. They often cause a burning sensation. A corn is a permanent change to your foot which will need care and management to stop it becoming too painful. You can manage corns by gently filing or pumicing them each week. You should never cut the skin with a blade.

Corns and calluses will usually grow back within four to six weeks unless you reduce the pressure on the area. Wearing softer, roomier footwear and placing a cushioned pad over the corn or callus can help.


A neuroma causes sudden shooting, stabbing, or burning pain. Most commonly it affects the third and fourth toes and the ball of your foot. It can feel like there is a small stone under your foot and your toes may become numb or tingly. It is caused by a damaged or irritated nerve and often becomes more painful over time. It is also known as Mortons neuroma and can be made worse by:


Clawed, mallet, retracted and hammer toes


Links To Orthopedic Foot Education

American Academy of Orthopaedic Surgeons This site is focused on providing current orthopedic information. It is full of multimedia information on many aspects of the orthopedic field. The link directs you to a section devoted to the foot and ankle. By clicking on the banner at the top more general information may be accessed.

U.S. National Library of Medicine National Institutes of Health –Foot injuries and disorders This site starts with a basic description of conditions that affect the foot. Scrolling further down the page reveals many links to topics about symptom recognition, treatment, rehabilitation, specific conditions, and other related information.

All patient education materials are provided by OrthoPatientEd.com and have been reviewed by our Advisory Board of leading Orthopedic Surgeons to ensure accuracy. All materials are provided for informational purposes only and are not intended to be a substitute for medical advice from your orthopedic surgeon. Any medical decisions should be made after consulting a qualified physician.

This site includes links to other websites. OrthoPatientEd.com takes no responsibility for the content or information contained in the linked sites.

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Retinacula Tendons And Their Synovial Sheaths Vessels And Nerves

A number of tendons pass through the ankle region. Bands of connective tissue called retinacula allow the tendons to exert force across the angle between the leg and foot without lifting away from the angle, a process called bowstringing.The superior extensor retinaculum of foot extends between the anterior surfaces of the tibia and fibula near their lower ends. It contains the anterior tibial artery and vein and the tendons of the tibialis anterior muscle within its tendon sheath and the unsheathed tendons of extensor hallucis longus and extensor digitorum longus muscles. The deep peroneal nerve passes under the retinaculum while the superficial peroneal nerve is outside of it. The inferior extensor retinaculum of foot is a Y-shaped structure. Its lateral attachment is on the calcaneus, and the band travels towards the anterior tibia where it is attached and blends with the superior extensor retinaculum. Along with that course, the band divides and another segment attaches to the plantar aponeurosis. The tendons which pass through the superior extensor retinaculum are all sheathed along their paths through the inferior extensor retinaculum and the tendon of the fibularis tertius muscle is also contained within the retinaculum.

Bones Of The Foot And Ankle

Ankle Anatomy Animated Tutorial

The bones of the foot and ankle include the phalanges, the metatarsals, and the tarsals. The calcaneus and the talus are the bones which make up the rear portion of the foot/hindfoot. The calcaneus meets the talus at the subtalar joint. The subtalar joint is what lets the food move from side-to-side.

Tarsal Bones

The tarsal bones are seven different bones. The seven different tarsal bones are: the first, second, and third cuneiforms, the navicular, the talus, the cuboid, and the calcaneus. The foot and leg muscles rotate the foot in one direction and the tarsal bones, as a result, form a rigid structure together. As the foot moves in the opposite direction, the tarsal bones become flexible once more.

The calcaneus is the largest bone out of all the tarsals. The function of the calcaneus is to absorb the weight of the body and transmit it into the ground. The calcaneus also functions as a lever that works upon of the calf muscles. The calcaneus is linked with the cuboid and talus. The talus, or ankle bone, is found on top of the calcaneus and is is the second largest of all the tarsals. Together with the fibula, tibia, calcaneus, and navicular, the talus forms a joint.

Metatarsal Bones


In all of the toes except the first toe, the phalanges located in the first-row bond together with metatarsal bones and create joints. They also form joints with the second phalanges, and these second-order joints form their own joints with the first and third phalanges.

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Bimalleolar Fractureand Bimalleolar Equivalent Fracture

A bimalleolar fracture occurs when both the medial malleolus and lateral malleolus are broken. Since there are injuries to both sides of the ankle, bimalleolar fractures are frequently unstable, and the ankle is often dislocated.

Nonsurgical Treatment

A stable bimalleolar fracture may be treated with cast immobilization for several weeks. During this time, you cannot put weight on your ankle. While you are in the cast, your doctor will take X-rays to make sure that the bones do not slip out of place.

Surgical Treatment

Because there are injuries to both sides of the ankle, most bimalleolar fractures need surgical repair. This is usually done with a plate and screws.

A bimalleolar fracture occurs when both the medial malleolus and lateral malleolus are broken.

Surgical repair of bimalleolar fracture with screws and plate and screws .

A bimalleolar equivalent fracture means that the ligaments on the inside part of the ankle are injured, and that only one bone has broken. The torn ligaments can cause the lower bone to shift and the ankle joint to go partially out of place or dislocate. Treatment involves putting the joint back in place and repairing the broken bone.

A bimalleolar equivalent fracture with torn ligaments on the medial side and a broken lateral malleolus.

Three Areas Of Bones In Each Foot

The 26 bones that are found in each foot are grouped into three categories. The talus and the calcaneus comprise the hindfoot, which represents the heel and where the foot attaches to the leg bone. The midfoot houses five small bones that are found between the ankles and toes, and they are referred to as the cuboid, navicular, and cuneiform bones. The bones that are between the foot and the toes are in the forefoot category and have 19 bones. Any of these bones can endure an injury, and a broken foot can happen when a bone is bent abnormally or twisted from a sudden accident. A broken heel can happen from landing after jumping from an elevated height. Common symptoms that many people experience with a broken foot consist of immediate swelling, bruising, and tenderness. Additionally, in bad fractures, the bone may protrude through the skin, causing severe pain. This can make it difficult or impossible to walk. If you have broken your foot, it is strongly advised that prompt medical attention is sought from a podiatrist who can perform a correct diagnosis and offer the best treatment solution for you.

A broken foot requires immediate medical attention and treatment. If you need your feet checked, contact the foot specialists from Academy Foot and Ankle Specialists. Our doctors can provide the care you need to keep you pain-free and on your feet.

Broken Foot Causes, Symptoms, and Treatment

Common Symptoms of Broken Feet:

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How Are Foot Or Ankle Problems Diagnosed

A healthcare professional will usually make their diagnosis after examining your feet. They will look for signs of swelling and any structural changes that could be causing the pain. You may also be asked to walk about, to see whether the problem affects your movement and posture.

Most of the time they can make a diagnosis without scans, x-rays or blood tests, unless they think your pain is being caused by a condition, such as arthritis.

General Anatomy Of The Foot And Ankle

Ankle &  Foot

The ankle joint is made out of the foot and leg bones together. The talocrural joint, or ankle joint, is where the legs distal end joins together with the foot. The ankle joint is where the talus and tibia join together. The tibia is the shin and it links with the talus, the topmost part of the foot. The ankle functions as both a huge joint and a synovial joint. The talus bone slots into fibula and the lower portion of the tibia. There are two bony protrusions that envelop the talus and sit on either side of the ankle. The hinge joint designation comes from the fact that the concave part of one bone fits onto the convex part of the adjacent bone.

The smaller fibula and the large tibia are the two leg bones which meet at the ankle joint and create a stable, supportive joint. This type of joint is referred to as a mortise and tenon joint. The ankle joint lets the foot extend and flex, or move down and up. The joint of the ankle is the most stable when the foot is pointed downward, or extended, compared to when the toes are pointed upwards. The ankle joint allows other movements as well, such as the rotation and tilting of the foot.

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What Causes A Broken Ankle

Broken ankles are usually caused by a rotational injury, where the ankle becomes twisted, turned or rolled while walking or running, such as during sports activity. But they can also be caused by a high-force impact, such as from a fall or automobile collision.

Breaks that occur suddenly, during a specific incident or injury, are known as traumatic ankle fractures. But a bone in the ankle can also break due to repetitive stress or impact over time. These are called stress fractures.

Why Do I Have Pain In My Foot Or Ankle

Most people experience pain in and around their feet or ankles at some point in their lives.

Its one of the most complex, hard-working regions of your body. It has 26 bones and 33 small joints, all held together by a network of soft tissue made up of muscles, tendons, ligaments, nerves, and blood vessels.

Most cases of foot or ankle pain are short term and are caused by soft tissue injuries, such as sprains or strains.

These should gradually heal with the help of simple self-care measures. Though some could take a few months to fully recover, you probably wont need to seek treatment from a healthcare professional.

However, some pain can have no obvious cause or may not improve significantly with self-care.

Pain that seems to be getting worse, does not improve, or lasts longer than a few months could be due to structural changes in the foot or ankle, or an underlying condition.

There can be several explanations for long-term pain in and around the feet or ankles, such as:

  • badly fitting footwear

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Movements And Muscles Involved

The ankle joint is a hinge type joint, with movement permitted in one plane.

Thus, plantarflexion and dorsiflexion are the main movements that occur at the ankle joint. Eversion and inversion are produced at the other joints of the foot, such as the subtalar joint.

Problems Linked To Low And High Arches

Ankle Fracture Surgery

Arches that are higher or lower than average can increase your risk of developing other problems, such as:

  • corns and calluses.

The self-care tips can help ease pain in your arches.

Changing your footwear to a well-made running trainer that you feel supports the shape of your arch may prevent further painful changes to the structure of your arches.

Insoles and arch supports can help but its best to visit a foot specialist, such as a podiatrist, to get ones designed specifically for your foot shape.

If youre buying new footwear its best to take any adaptations, such as insoles, padding, or arch supports with you, as you may need a larger shoe size to fit them in comfortably.

Losing weight, if you need to, can reduce the strain on your arches and may prevent further long-term changes.

You may find it difficult to do exercises that put a lot of pressure through your feet. Swimming is a good way to improve and maintain your fitness because the water supports your body weight.

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What Is The Recovery Time Of A Broken Ankle

It takes about six weeks for bones to heal. It may take longer for ligaments or other soft tissues to heal as well.

After surgery, patients are typically not weightbearing for 4 to 6 weeks until the bone heals. Patients are placed on a pain management protocol that minimizes their need for opioid medications. For the first couple of weeks, patients are in a splint and are elevating the limb 90% of the day. After 10 to 14 days, the sutures are removed and patients are typically placed into a removable boot. This allows patients to start moving the ankle and to shower. At the six-week visit, X-rays are obtained. Assuming the bone is healed well, patients are then allowed to start weightbearing and to begin physical therapy. Patients will generally have six weeks of therapy or more if required.

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