Inflammation of achilles tendon; insertional or noninsertional
Tendonitis / Tendonosis / Rupture
Triceps surae
- medial and lateral gastrocnemius
- soleus
- surrounded by paratenon which allows gliding and supplies nutrition
Inserts middle 1/3 calcaneal tuberosity
- 2 x 2 cm area
- 90o rotation distally
Retrocalcaneal bursa (x2)
Pain at attachment of thickened central part of plantar aponeurosis to Medial Calcaneal Tuberosity
Origin
- medial calcaneal tuberosity
Inserts
- 5 bands superfical & deep layers
Superficial
- insert transverse MT ligament & skin
Deep
- flexor sheath, volar plate & periosteum of P1
Lateral compartment of leg
- run through retromalleolar groove
- pass superior and inferior to peroneal tubercle
- covered by inferior peroneal retinaculum
Peroneus longus
- origin lateral condyle of tibia and head fibula
- tendon PL superficial and inferior to brevis in retromalleolar groove
- runs in cuboid groove
- insert plantar surface base of 1st MT and lateral aspect medial cuneiform
Entrapment neuropathy of posterior tibial nerve within the tibial tunnel
Flexor Retinaculum
- medial malleolus to posterior calcaneum
Tarsal tunnel
- roof is flexor retinaculum
- tibia anteriorly
Crushing osteochondritis of metatarsal head
Usually 2nd metatarsal (80%)
- occasionally third
- can occur in any
Age 10-15 years
- peak 15 year old girls
- F:M = 3:1
- occurs during the growth spurt at puberty
Bilateral in 6%
A. Ankle Fracture
Types
- Weber A 4%
- Weber C 33%
- Displaced large posterior malleolar
Any OA develops in first 2 years
Causes
- articular damage at time of injury
- non anatomical reconstruction
- complications i.e. infection
A: Alignment
B: Bony
C: Canal
D: Disc
S: Soft tissues
1. Correct deformity
2. Restore stability
3. Decompress neural elements if required
Advantage
- defines level of conus
- may need anterior rather than posterior surgery if lesion above conus
Spondylolithesis caused by
- facet joint degeneration
- no pars or dysplastic pathology
- disc space usually preserved
Most common at L4/5 level
More common in elderly females
- F: M = 5:1
Diabetics
Reduction of space available for neural elements in spinal canal or intervertebral foramina
- due to degenerative changes, congenital abnormalities or both
- involves compression of the thecal sac or nerve roots
Onset 50 - 60's
- M = F
- associated with onset OA spine
0.05% incidence
- rare due to stabilising effect of rib cage
- even more rare to have symptoms
Reasoning
1. Discs are narrower
2. Foramina larger
3. Thoracic spine
- facet joints orientated for rotation
- lumbar spine for flexion extension
- flexion is typically the motion which ruptures annulus