The movements of the ankle-joint / by W. Arbuthnot Lane.

  • Sir William Arbuthnot-Lane, 1st Baronet
Date:
[1888]
Catalogue details

Licence: Public Domain Mark

Credit: The movements of the ankle-joint / by W. Arbuthnot Lane. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    tibial facets, but the astragalus articulates with the tibia solely by the concave facet on the upper surface of the prominence on its posterior surface. Its outer articular surface is fixed immov- ably to the corresponding facet on the outer malleolus. The interval that exists between the opposing surfaces of the tibia and astragalus while in this position is occupied by an interarticular synovial fold, which contains fat and projects from the posterior surface of the anterior ligament of the ankle-joint. In those who habitually perform this movement of complete extension of the ankle-joint this interarticular synovial structure is remarkably well developed. In a slightly less degree of extension portions of the upper and inner facets on the astragalus come into contact with their corresponding surfaces on the tibia. In complete extension the outer malleolus is drawn slightly downwards and inwards by the strain exerted upon it by the strong anterior fasciculus of the external lateral ligament, and also inwards by the posterior fasciculus of the same ligament. I would point out here that the latter portion of the external lateral ligament limits and opposes movements both of complete flexion and complete extension of the ankle-joint, for the reason that its fibres occupy a horizontal plane, and the interval between its points of attachment is least where the joint occupies a position midway between complete flexion and extension. Any devia- tion from this posture, either in the direction of flexion or ex- tension, renders the fibres of this ligament oblique, separating its bony attachments and making it tense. In extreme flexion of the ankle-joint the posterior fasciculus is rendered tense, and exerts a traction upon the lower end of the fibula in a direction inwards, backwards, and downwards, while in extreme exten- sion the same band of fibres tends to draw the malleolus inwards, backwards, and upwards. In the latter position the strain exerted by the tense anterior fasciculus of the external lateral ligament in a direction from above downwards, forwards, and inwards displaces the fibula slightly downwards. This move- ment of the fibula is limited by all the tibio-fibular ligaments and by the posterior fasciculus of the external lateral ligament. In extreme extension the anterior portion of the deltoid liga- ment is rendered very tense.
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