The structure of the foot

At the rear of the foot and the sole release, spaced apart inner and outer edges of the foot. The back part of the foot is the calcaneus, or heel. The right foot is usually slightly longer than the left.

The bones of the foot is conventionally divided into three parts: the tarsus, metatarsus and toes. The structure includes seven tarsal bones:

• anklebone - very large bone in the human body the meniscus (the bone bounded by sickle-shaped surface), located between the bones of the leg and foot;
• calcaneus - it tuberosity forms the basis of the heel;
• navicular bone;
• cuboid;
• 3 cuneiform bones (inner, intermediate and outer).

Hock formed by five short tubular bones. The skeleton of each finger and thumb (there are two phalanges), consists of three tubular bones - phalanges.

The bones of the foot are interconnected joints, among which are distinguished:

• ankle joint;
• 4 joints between the bones of the tarsus (two of them united under the name cross-tarsal joint);
• 3 joints between the bones of the tarsus and metatarsus (they are united in a joint called Lisfranc joint);
• between the bones of the metatarsus;
• between the metatarsals and phalanges;
• between the individual phalanges.

The strengthening of the foot involves a large number of ligaments, among which is of particular importance talocalcaneal interosseous ligament, reinforcing cross-tarsal joint. At the bottom of well defined long plantar ligament, which is one of the clamps longitudinal arch. Strengthen foot muscles and fascia as (connective tissue sheath covering the muscles) tibia.

Tarsal and metatarsal bones are connected by ligaments and muscles through a series of springy arches that give elasticity gait. The foot has five longitudinal arch corresponding to the five metatarsal bones, which are connected by a transverse arch.

Causes of dislocation of the foot

Sprains or persistent displacement of the articular surfaces of bones relative to each other in the joints of the foot are rare, since the degree of displaceability of certain bones of the foot relative to each other is minimal. Sprains occur under the influence of large damaging forces, most of all - it drop.

Subtalar dislocation of the foot

Subtalar dislocation of the foot (sprain in talocalcaneal-navicular joint) is observed more often in the fall on the outer edge of the foot. The stack thus displaced inwardly and rotated such that the plantar surface turns toward healthy leg. Other subtalar dislocation Dislocation - Prevention and Treatment   (laterally, posteriorly and anteriorly) are very rare. On radiographs in this dislocation can be seen throughout the displacement of the foot with the exception of the talus, which remains in the ankle joint.

When podtarannnom dislocation is necessary as soon as possible to make its closed reduction, as this often happens compression of blood vessels and poor circulation, which can cause irreversible changes in the tissues of the foot. Reduction is performed under general anesthesia or intraosseous anesthesia (anesthetic drug is injected directly into the bone). Next, the motion in the foot, return to those that led to the dislocation. After 6 weeks reposition impose a plaster cast from the fingertips to mid-thigh. If closed reduction was not possible, the conduct emergency surgery.

Lisfranc dislocation in the joint

Dislocations in the Lisfranc joint may be complete (all metatarsal bones) and isolated (mainly I metatarsal bone). These dislocations are often combined with fractures of the metatarsal bones that is called in this case perelomovyvihami. Observed sprains metatarsal upwards downwards, outwards, inwards and in different directions.

Closed reduction of dislocation is taken immediately, since this injury often joins circulatory disorders. Under general anesthesia produced a one-time extension of the final limb of the foot and the pressure acting on the base of the metatarsal bones. To keep the progress reposition need a special fixation of two or three metal spokes. Then applied a plaster cast on the foot and lower leg for 6-8 weeks. If closed reduction failed to produce rapid reduction.

Dislocations toes

Sprains Finger possible in the metacarpophalangeal and metatarsophalangeal-interphalangeal joints with excessive extension or flexion of the toes. There are rear or plantar dislocation. Dislocation in all metatarsophalangeal joint is clearly visible on the radiograph of the foot.

When dislocation of fingers held it closed reduction. If this is not possible, or in severe cases by open reduction with fixation of the bones in the right position with the spokes.

First aid sprains foot

If you suspect a dislocated his foot in any case can not reduce a self - it can only worsen the condition of the victim. Such a person needs to drink any anesthetic, which is at hand, and to impose an impromptu bus, that is, to give the leg immobility, and then bring the victim to the emergency room. For the tire can come any improvised material (board, umbrella, etc.), which will help to fix the foot and knee.

Galina Romanenko

How does the stop

The stack is a set of bones, conventionally divided into three parts tarsus, metatarsus and toes.

Tarsus - the back part of the foot, it includes seven bones (talus, heel, scaphoid, cuboid, and three cuneiform). Hock - the middle of the foot, it is formed by five short tubular bones. The front part of the foot - toes, each of which is composed of three bones - the phalanges in the first toe has only two phalanges.

The bones of the foot are interconnected by means of joints, which gives the foot mobility and flexibility. This ankle, four joints between the bones of the tarsus, three joints between the bones of the tarsus and metatarsus, and the small joints between the metatarsals, metatarsals and phalanges and the individual phalanges.

Foot reinforced shin muscles and fascia and ligaments which unite the bones, form the arches of the foot - it damping device that allows a person to bounce while walking. The foot has five longitudinal arch corresponding to the five metatarsal bones, which are connected by a transverse arch.

Fracture of the foot and the first aid

Fractures of the foot can result from a direct blow (eg, a fall from a height on foot or with a strong impact on the bones of the foot) - the so-called direct mechanism of injury. Meet and indirect mechanism of injury when the force is not directly on the affected bone. For example, if the foot is squeezed from all sides, and in the lower leg produced a sharp rotational movement (often, in order to free the jammed leg) - such a move may lead to fracture of the shin bone, and a fracture of the bones of the foot.

If you suspect a fracture of the foot must be conducted X-ray of the foot, which not only confirm the diagnosis, but also allows you to choose the right tactics treatment.

If you suspect a fracture of the foot, the victim need to give first aid. To do this, you need to give the injured leg immobility - it can be done with the help of the bus (any plate length just above the knee) that pribintovyvayut to the leg. After splinting need to call an ambulance or by the victim to deliver to the traumatologist.

Fracture of the talus

Astragalus is located between the bones of the lower leg and foot. Its fractures occur generally by indirect injury. This can happen during heavy plantar flexion of the foot, a fall from a height when the blow falls on the heel bone. In the latter case, the body of the talus is crushed between the tibia and the calcaneus (compression fracture).

In the field of crisis there is a sharp pain, aggravated by tapping the heel, ankle increases in the amount of motion in it becomes impossible.

Treatment of fractures without displacement of bone fragments is applying plaster bandage from the toes to the knee with modeling arches of the foot. Depending on where the fracture of the plaster is applied for a period of 6 weeks to 3-4 months. After removing the plaster cast prescribed duration (4-5 months) discharge (walking on crutches), warm baths, physiotherapy, massage, wearing orthopedic insoles Orthopedic insoles - what are they for? .

For fractures with displacement of bone fragments under local or general anesthesia is their closed manual reduction (repositioning). If this is not possible, open reduction surgery is performed fragments and their subsequent fixation with needles.

Fracture of the calcaneus

The cause of the fracture of the calcaneus Fractures of the calcaneus - forecast favorable   often a direct trauma of the bones - drop on the heels.

Manifested fracture of the calcaneus sharp pain that is worse with pressure on the heel bone from the sides and bottom of the load on the heel or lifting the toes impossible. Heel with the expanded arch flattened.

Treatment of fractures without displacement carried casting of knee for a term of 3 to 8 weeks depending on the type of fracture. For fractures with displacement under local anesthesia is performed manually closed reposition of bone fragments, while the impossibility of closed reduction - open with subsequent fixation of bone fragments using various devices.

Fracture of the tarsal bones

Fracture of tarsal bones occur in the fall of gravity on foot. This may be damaged by one or more bones. At the site of the fracture occurs swelling and tenderness, which is enhanced by turning the feet. The victim can walk, but relies only on the heel.

For fractures without displacement impose a plaster cast with the modeling arches of the foot for 3-4 weeks. For fractures with displacement of fragments held their closed or open reduction followed by casting of.

Jones fracture and phalanges

The cause of these fractures are most often fall in gravity to the rear of the foot or a sudden hyperextension. Manifested fracture sharp pain, aggravated by pressure on the metatarsal head, the increased mobility of the affected part of the foot.

The affected foot plaster cast is applied to the knee with modeling arches of the foot for 2-3 weeks (if the pieces are not displaced) or reposition held (closed or open) fragments.

At the turn of the phalanges no displacement of bone fragments at the foot bandage of plaster for two weeks for fractures with displacement of fragments carried skeletal traction for the terminal phalanx.

Galina Romanenko