Foot & Ankle
Foot & Ankle Anatomy
The foot and ankle is a complex joint involved in movement and providing stability and balance to the body. The foot and ankle consists of 26 bones, 33 joints, and many muscles, tendons and ligaments.
A sprain is the stretching or tearing of ligaments, which connect adjacent bones and provide stability to a joint. An ankle sprain is a common injury that occurs when you suddenly fall or twist the joint or when you land your foot in an awkward position after a jump.
Achilles Tendon Rupture
Achilles tendon is a strong fibrous cord present behind the ankle that connects the calf muscles to the heel bone. It is used when you walk, run and jump. The Achilles tendon ruptures most often in athletes participating in sports that involve running, pivoting and jumping. Recreational sports that may cause Achilles rupture include tennis, football, basketball and gymnastics.
Plantar fasciitis refers to inflammation of the plantar fascia, a thick band of tissue that lies at the bottom of the foot. It runs from the heel bone to the toe and forms the arch of your foot.
The ankle joint is composed of three bones: the tibia, fibula, and talus which are articulated together. The ends of the fibula and tibia (lower leg bones) form the inner and outer malleolus, which are the bony protrusions of the ankle joint that you can feel and see on either side of the ankle.
Ankle instability is a chronic condition characterized by a recurrent slipping of the outer side of the ankle. It usually results from repeated ankle sprains. It is generally noticed during movement of the ankle joint but can also occur during standing as well.
Nail Bed Injuries
The nail is composed of a nail plate, nail matrix and nail bed. The nail bed is the soft tissue that lies below the nail and is essential for the growth of the nail. Nail bed injuries such as crush and avulsion injuries are commonly associated with injuries to the hands or fingertips.
Osteochondral Injuries of the Ankle
The ankle joint is an articulation of the end of the tibia and fibula (shin bones) with the talus (heel bone). Osteochondral injuries, also called osteochondritis dissecans, are injuries to the talus bone, characterized by damage to the bone as well as the cartilage covering it. Sometimes the lower end of the tibia or shin bone may also be affected.
Stress Fracture of the Foot
A stress fracture is a small crack in the bone which occurs from overuse injury. It commonly develops in the weight-bearing bones of the lower leg and foot. When the muscles of the foot are overworked, or stressed, they are unable to absorb the stress and transfer it onto the bone, which cracks under the pressure.
Shin splints or medial tibial stress syndrome (MTSS) is pain around the tibia or shin bone due to inflammation of the tendons, muscles and bone tissue. It occurs because of vigorous physical activity such as with exercise or sports.
The calcaneus or heel bone is a large bone found at the rear of the foot. A fracture is a break in a bone from trauma or various disease conditions. The types of fracture to the calcaneus depend on the severity and include stable fractures, displaced fractures, open fractures, closed fractures and comminuted fractures.
Lisfranc (Midfoot) Fracture
The Lisfranc joint or tarsometatarsal joint refers to the region in the middle of the foot. It is a junction between the tarsal bones (seven bones in the foot arch) and metatarsal bones (five long bones in the foot). Lisfranc fracture scan occur due to a fall from a height or traumatic motor accidents.
The talus is a small bone at the ankle joint that connects the heel bone and the shin bones, enabling the up and down movement of the foot. Fractures in the talus bone may occur due to a fall from great heights, motor vehicle accidents or sports injuries. Symptoms include severe ankle pain, inability to walk, swelling and tenderness.
Toe and Forefoot Fractures
The forefoot is the front of the foot that includes the toes. Fractures occurring in this part of the foot are painful, but very often not disabling. There are 2 types of fractures namely, traumatic fracture and stress fracture.
Turf toe is an injury to the ligament at the base of the big toe. It is a painful condition which usually results from jamming of the toe into the ground or excessive backward bending of the toe. As it is more common in athletes playing on artificial turf, especially those involved in field sports such as football, baseball and soccer, it is known as turf toe.
The foot has 26 bones, and can be divided into 3 parts:
- The hind foot is comprised of two bones, the talus bone which connects to the bones of the lower leg, and the calcaneus bone which forms the heel.
- The midfoot is comprised of the navicular, cuboid, and three cuneiform bones.
- The forefoot is made up of five metatarsal bones and 14 toe bones called phalanges.
Foot and Ankle Trauma
The foot and ankle in the human body work together to provide balance, stability, movement, and propulsion.
Ankle Ligament Injury
Ankle ligament injury, also known as ankle sprain, can be caused by a sudden twisting movement of the foot during any athletic event or during daily activities. It is one of the most common orthopaedic injuries and can also be caused by walking down a slope or over any uneven surface.
Osteochondral injuries are one of the most common causes of ankle pain. Though in most cases there is a history of injury or trauma to the ankle joint, a few cases may not have any previous history of ankle injury.
Foot and Ankle Osteoarthritis
Achilles Tendon Bursitis
Achilles tendon bursitis or retrocalcaneal bursitis is a condition that commonly occurs in athletes. It is a painful condition caused by swelling of bursa, a fluid-filled sac which is located at the back of the heel under the Achilles tendon.
A bunion is a bony protuberance that appears on the external surface of the big toe when it angles toward the adjacent toe. It is an extra bone and a fluid-filled sac that grows at the base of the big toe.
Athlete's foot also known as tinea pedis, is a fungal infection on the skin of the foot. It is characterized by itchy, moist, white, scaly lesions between the toes that can spread to the sole of the foot.
Forefoot pain, also referred to as metatarsalgia, is a type of pain that occurs in the ball of the foot (around the tip of the metatarsal bones). Generally, forefoot pain is associated with aging. Individuals with metatarsalgia experience pain of varied intensity and discomfort and find difficulty in activities like walking, running, playing, and several others.
In toeing also called “pigeon-toed”, is an abnormal condition characterized by inward facing of the toe or feet instead of being straight. Parents may observe their children having intoeing at an early age when they start walking.
Morton’s neuroma refers to a nerve injury between the toes, usually the third and fourth toes, which causes pain and thickening of the nerve tissue. Compression or chronic irritation of this interdigital nerve is the main cause of Morton’s Neuroma.
Foot pain occurs from distress induced by certain factors in the foot. Foot pain is a common problem experienced by young athletes involved in different activities such as running and jumping.
Flatfoot, also known as “fallen arches” or Pes planus, is a deformity in children’s feet in which the arch that runs lengthwise along the sole of the foot has collapsed to the ground or not formed at all.
Fungal infections are common in nails, and occur most often in toe nails. Termed as onychomycosis, nail fungus affects the keratin, the hard material that makes up the nail and can include the entire nail or a portion of the nail, along with the nail root, plate or bed.
Foot infections may occur after trauma to the foot or loss of tissue because of contamination from foreign material and/or bacteria or fungus. Infections can occur in healthy individuals as well as in those whose health is compromised.
Foot drop also known as drop foot, is a sign of an underlying muscular, neurological or anatomical condition, where you are unable to lift the front part of your foot, resulting in foot dragging.
A hammertoe is a deformity of a lesser toe (second through fifth toes), where the toe gets bent upward at the toe’s middle joint, resembling a hammer. The bent portion may rub against a shoe causing pain, irritation and development of corns.
Mallet finger is a condition where the end of the finger is bent and does not straighten. It occurs when the extensor tendon on the back of the finger is damaged. The finger joint is a hinge-joint that allows bending and straightening of the fingers.
Claw toe is a deformity, where a toe bends and appears like a bird’s claw. The affected toe is bent upward from the joint at the ball of foot, and downward at the joints in the middle and tip of the toe to curl under the foot.
Limb deformities can be congenital (present at birth) or develop at a later stage because of fracture, infection, arthritis or tumor. Congenital deformities of the lower limbs are developmental disorders that cause alterations in the shape and appearance of the legs.
Club Foot and Congenital Deformity
Congenital deformities of the lower limbs are developmental disorders that are present at birth, causing alterations in the shape and appearance of the legs. Several factors such as genetics, teratogenic drugs and chemicals can cause congenital deformities.
An ingrown toenail is a common and painful condition of the toe. It occurs when the sides or corner of the nail grow inwards and penetrates the skin of the toe. Pain is often accompanied by swelling and redness. The big toe is affected most often.
A corn is a circular area of thickened skin developed because of continuous friction or pressure. They usually develop on the soles of feet, or on the top or sides of toes, and appear as yellowish dead tissue surrounding an area of tenderness.
The heel is made up of the calcaneus bone and supported by a network of muscles, tendons, ligaments and soft tissues, which together support the weight of the body and stress during movement. Heel pain is a common symptom of excessive strain placed on these structures.
Feet support your body weight, help maintain proper posture and help in movement. As the feet bear the entire weight of the body and are involved in most activities, they are more prone to problems such as calluses, corns, cracks, infections and traumatic injuries.
Foot Activity and Exercise Guide
A foot injury or foot surgery may leave you immobile for a period. To return to your regular activities and more strenuous recreational activities, it is necessary for you to follow a well-planned activity and exercise program.
A bunion, also known as hallux valgus, is bony prominence at the base of the big toe, which often results in pain, redness and rubbing in footwear. The 1st metatarsal bone abnormally angles outward towards the other foot from its joint in the midfoot.
Foot reconstruction is a surgery performed to correct the structures of the foot and restore the natural functionality of the foot that has been lost due to injury or illness. Ideally, any foot surgery for reconstruction is done to improve the appearance and function of the foot so that patients can maintain their quality of life.
Ankle Joint Replacement
The ankle joint connects the leg with the foot and provides free movement to the foot. It is formed by connecting the bones of the lower leg, tibia and fibula, with the talus, or ankle bone.
Subtalar arthrodesis is the surgical fusion of bones that form the subtalar joint. The subtalar joint is a complex joint located below the ankle joint and is formed by the union of the heel (calcaneus) and the talus (ankle) bone.
Foot and Ankle Surgery
Ankle arthroscopy is a minimally invasive surgical procedure in which an arthroscope, a small, soft, flexible tube with a light and video camera at the end, is inserted into the ankle joint to evaluate and treat a variety of conditions.
Minimally Invasive Foot Surgery
Minimally Invasive Foot Surgery (MIFS) uses the latest advanced technology to treat foot and ankle pain caused by a variety of conditions. Special surgical instruments, devices and advanced imaging techniques are used to visualize and perform the surgery through small incisions.
Treatment of Foot and Ankle Sports Injuries
Injuries during sports are common. They can result from accidents, inadequate training, improper use of protective devices, or insufficient stretching or warm-up exercises. Injuries to the foot and ankle are common while playing sports such as football, hockey, skating and in weekend athletes.
Cavovarus Foot Correction
To support the entire body’s weight on your two feet, the inner middle portion of each foot (midfoot) is raised off the ground to form an arch. A cavovarus foot deformity is characterized by a higher-than-normal arch of the inner midfoot. This results as the two ends of the foot - the heel and toes - abnormally draw towards the inside of the foot, causing the foot to rest on its outer side.
Foot reconstruction is a surgery performed to correct the structures of the foot and restore the natural functionality of the foot that has been lost due to injury or illness.
Ankle arthrodesis is the surgical fusion of bones that form the ankle joint. The ankle joint is formed by the tibia, talus, and the fibula bones.
Ankle Ligament Reconstruction
A sprain is stretching or tearing of a ligament. Ligaments connect adjacent bones in a joint and provide stability to the joint.
Ankle tenotomy is a surgical procedure to lengthen the Achilles tendon enabling the ankle to flex upward and allowing the heel to be placed flat on the floor. It is indicated in patients that have an abnormally developed Achilles tendon or one that has become shortened and difficult to stretch.
Ankle Instability Surgery
Ankle instability surgery is performed to treat an unstable ankle and involves the repair or replacement of a torn or stretched ligament.
Click on the topics below to find out more from the orthopaedic connection website of American Academy of Orthopaedic Surgeons.
- Achilles tendon
- Adult (Acquired) Flatfoot
- Arthritis of the Foot and Ankle
- Ankle Fractures
- Athletic Shoes
- Rotura de tobillo (Broken Ankle)
- Broken Ankle
- Diabetic foot
- Flexible flatfoot in children
- Foot Pain
- Fracture of the Talus
- Fractures of the Heel
- Hammer toe
- Heel Pain
- Ingrown Toenail
- Orthotic Devices
- Pediatric Thigh Bone Fracture
- Plantar fasciitis
- Posterior Tibial Tendon Dysfunction
- Rheumatoid Arthritis of the Foot and Ankle
- Sprained Ankle
- Stiff Big Toe (Hallux rigidus)
- Stress Fractures of the Foot and Ankle
- Toe and Forefoot Fractures