Higgins lower leg notes
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| inferior tibiofibular | syndesmosis w/ no articular cartilage or synovium, ant and post talofibular ligaments prevents seperation to tib and fib, w/ DF talar head seperates this joint w/ force, DF, IR, ER, the talofibular ligaments are stressed
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| Compartments | anterior, superficial posterior, deep posterior, lateral
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| Anterior compartment | Anterior Tibialis, Extensor digitorum longus, extensor hallicus, deep peroneal nerve, anterior tibial artery and vein,
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| lateral compartment | superficial peroneal nerve, short and long peroneal muscle
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| Superficial posterior compartment | soleus muscle, plantaris, gastroc tendons
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| deep posterior compartment | posterior tibial muscle, flex digitorum longus, flexor hallicus longus, peroneal artery and vein, tibial nerve, posterior tibial artery and vien
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| Anterior tibiofibular | runs downward and inward from distal fibula to the distal tibia, prevents seperation of syndesmosis
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| posterior tibiofibular | runs downward and inward from the distal fibula to the distal tibia, prevents syndesmosis
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| Interosseous membrane | runs the length of the tibi and fibula , connecting the two leg bones, prevents seperation of tibia and fibula
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| percussion/bump and compression test | used when fx is suspected, percussion test is a blow to the tib, fib, or heel to cause vibration that resonates in fx causing p!, compression test-compression of tib &fib either above or below site of concern
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| Syndesmotic sprain | etiology-torn w/ increased ER or DF, injured in conjunction w/ med and lat ligaments, may require extensive repair time ,
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| Syndesmotic sprainSX | pt and swelling localized over ant and post tibiofibular ligaments, bilateral compression increase p!, walk on toes, inability to push off
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| Syndesmotic sprain TX | ICER, immobilization usually for period of 2-3 wks depends on severity of mortise sprain, NSAIDs
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| Acute leg Fx | causes:direct blow or indirect trauma, fib fx seen w/ tib fx or as a result of direct trauma, sigs-p!, swelling, soft tissue insult, leg will look hard and swollen(Volkmans contracture), deformity-maybe open or closed
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| Stress fx of tib and fib | cause-common overuse, particularly w/ structural & biomechanics insuffecencies, result of repetative loading during training & conditioning, signs-p! w/ activity, p! increased after exercise, pt difficulty discerning bone&soft tissuep!, bone scan results
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| Medial Tibial Stress syndrome causes of injury | p! ant/post shin, stress fx, muscle strains, chronic ant comp synd periosteum irritation, repetative microtrauma, weak muscles, improper footwear, training errors, varusfoot, tight heelcord, hypermobile/pronated feet, stress fx &exertional comp synd
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| MTSS signs of injury | difuse p! in disto-med aspect of lower leg, in bad cases ambulationmaybe p!, morning p! and stiffness may also increase, can progress to stress fx
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| Anterior | etiology-result of hard heelstike w/ landing phase of running, overuse of DF occurs, presentation-p!lat to tib, w/ increased ex, over ant comp, dull ache
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| posterior | etiology-associatd w/ inflam to post tib tendon &long toe hallux toe, hyperpronationof foot during midstance, presentation-p! over med border of distal tib, w/ increased ex, dull ache, pronated subtalar joint
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| Compartment syndrome | cause-rare acutetraumatic syndrome caused by direct blow, can be acute, acute exertional, chronic, signs-excessive swelling, compresses muscles blood supply&nerves, deep achin p! tightness, weakness w/ footand toe ext, numbness in doralreagion of foot
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| achilles tendonitis etiology | p! and inflammation of achilles tendon usuall 2-5cm proximal to calcaneus, weak gastroc soleus comples, overuse, decreased DF, pronation
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| achilles tendonitis presentation | p! w/ activity, decrease p! w/ rest, p! and decreased DF, crepitation, tightness in achilles, p! w/ PF
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| Achilles tendonitis cause of injury | inflammatory condition, sheath or paratenon, tendon overloaded due to extensive stress, gradual onset and worsens w/ continued use, decreased flexibility exacerbates condition
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| Achilles tendonitis signs of injury | generalized p! and stiffness, localized proximal to calcaneal insertion, warmth p! w/ palpation, thickened, mayprogress to morning stiffness
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| Achilles tendon rupture | cause-suddent stop &go, forcefull PF w/ knee moving to ext, seen mor ein ath 30+, history chronic inflammation signs-sudden snap(shot in leg), instant p!, pt, swelling, discoloration, decreased ROM, indentation, + thompson test
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| Shin contusion | Cause-direct blow to lower leg-impacting periosteum anteriorly), Signs-intense p!, rapid forming hematoma w/ jelly like consistency, increased warmth
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