The ankle joint is a block-shaped joint formed by the articular surfaces of the distal ends of the large and tiny bones and the articular surface of the talus block. Both tibia bones are connected together by ligaments and form a fork covering the upper and lateral surfaces of the body of the talus. The articular surfaces of the bones are covered with hyaline cartilage. The joint bag is strengthened by strong ligaments (Figure 1).
The ankle region has characteristic contours. Anteriorly on the ankle bend are exposed through the skin of the tendon of the extensors of the fingers and the anterior tibial muscle, behind - the Achilles tendon ligament, from the sides - the medial and lateral ankles.
The ankle joint is supplied with blood from the anterior and posterior tibial arteries. Pulsation of the first of these is determined on the anterior surface of the ankle joint, and the second - behind the inner ankle. The skin on the front surface of the ankle and in the area of the ankles is directly attached to the bone.
Movement in the ankle mainly occurs in two directions: in the plantar - bending and in the rear - extension. The amplitude of these movements in adults reaches 60-70 °.
Of the injuries of the ankle joint may be a bruise (see), distortion (see) and ruptures of the ligament apparatus; fractures of the ankles, combined with a fracture of the inferior posterior or anterior edge of the tibia with a rupture of the inferior intercellular junction.
Fracture of the fibula at 6-8 cm above the tip of the external ankle, in combination with a fracture of the inner ankle, is called the Dupuytren fracture (Fig. 2). It is similar to Pott's fracture, in which the fracture of the fibula occurs at the level of the ankle joint joint.
There are fractures of the ankles with a subluxation of the foot outward, combined with subluxation to the back, less often - ankle bias with displacement and subluxation of the foot inside (Malenga fractures). In the ankle joint, isolated and combined fractures and fractures of the talus bone are observed. Fractures of the ankle without displacement of fragments and dislocation of the foot are more difficult to diagnose than fractures with displacement, since swelling, bruising and pain in the ankle can be small, and there is no deformation. At the slightest suspicion of a fracture, it is necessary to make an x-ray of the ankle in two projections.
First aid for fracture of the ankle joint - immobilization with the aid of Cramer's tire. In such a situation, the patient is transported to a medical institution. Fractures and fractures in the ankle require urgent adjustment, which is carried out in a hospital under local intraosseous anesthesia or anesthesia; after the correction, a plaster bandage is applied. If the fragments and subluxations can not be corrected, surgical treatment is indicated.
Open fractures of the ankle in peacetime are relatively rare. Gunshot ankle fractures are observed often in wartime.
First aid for open and gunshot injuries of the ankle joint consists in the application of an aseptic bandage and transport immobilization. In the medical institution, antitetanous serum (3000 AE in Besedke), penicillin , primary wound treatment, reposition of fragments and impose a plaster bandage are injected.
Inflammatory diseases of the ankle joint of traumatic and infectious origin ( tuberculosis ), rheumatoid arthritis, arthrosis, etc. are also observed (see Arthritis, Tuberculosis of bones and joints ).
See also Joints .