Fractured medial malleolus
Fractured medial malleolus
Eversion of foot
Figure 19-6. (A) Anteroposterior radiograph and diagram of an inversion injury of the left ankle. The radiograph shows avulsion of the fifth metatarsal (black arrow) caused by the pull of the tendon of the peroneus brevis muscle. The epiphyseal growth plate is oriented vertically (white arrow). In addition, in an inversion injury, the anterior talofibular ligament usually is torn and the fibula is fractured. (B) Anteroposterior radiograph and diagram of an eversión injury of the left ankle. The radiograph shows fracture of the fibula (A), avulsion of the medial malleolus (S), lateral movement of the talus (C), and a widened interosseous space (D). (A reprinted with permission from Eisenberg RL: Diagnostic Imaging in Surgery. New York, McGraw-Hill, 1987, p 743; B reprinted with permission from Levy RC, Hawkins H, Barsan WG: Radiology in Emergency Medicine. St. Louis, CV Mosby, 1986, p 427.)
2. Eversion injury (Pott fracture) occurs when the foot is forcibly everted and results in the following injuries:
a. Avulsion of the medial malleolus, which occurs because the medial (deltoid) ligament is strong and resists tearing b. Fracture of the fibula as a result of lateral movement of the talus
3. Ski boot injury usually results in fracture of the distal portions of the tibia and fibula.
4. Calcaneal (lover's) fracture occurs when a person jumps from a great height (e.g., a second story window). It usually involves the subtalar joint and is associated with fractures of the lumbar vertebrae and the neck of the femur.
5. Lisfranc injury occurs when a bicyclist's foot is caught in the pedal clips. It also may be caused by high-energy trauma (e.g., car accident). It causes fracture or dislocation at the tarsometatarsal (Lisfranc) joint.
VIII. CROSS-SECTIONAL ANATOMY OF THE LEFT THIGH AND LEG (Figure 19-7)
Figure 19-7. (/4) Cross-section through the left thigh. Black lines indicate the divisions of the ^ extensor (anterior), flexor (posterior), and adductor (medial) compartments. AB = adductor bre-vis; AL = adductor longus; AM= adductor magnus; BF= biceps femoris; FA = femoral artery; FE = femur bone; FN = femoral nerve; FV= femoral vein; GM = gluteus maximus; GR = gracilis; ON = obturator nerve; PFA = profunda femoris artery; PFV = profunda femoris vein; RF = rectus femoris; SM= semimembranosus; SN = sciatic nerve; SR = sartorius; ST= semitendinosus; VI = vastus intermedius; VL = vastus lateralis; VM = vastus medialis. (B) Cross-section through the left leg. Black lines indicate the divisions of the extensor, flexor, and lateral compartments. ATA = anterior tibial artery; ATV= anterior tibial vein; DPN= deep peroneal nerve; EDL = extensor dig-itorum longus; EHL = extensor hallucis longus; F= fibula; FDL = flexor digitorum longus; FHL = flexor hallucis longus; GSV= great saphenous vein; PA = peroneal artery; PB = peroneus bre-vis; PL = peroneus longus; PTA = posterior tibial artery; PTV = posterior tibial vein; PV = peroneal vein; S= soleus; SAN= saphenous nerve; SPN= superficial peroneal nerve; TA = tibialis anterior; TB = tibia; 77V = tibial nerve; TP = tibialis posterior. (Adapted with permission from Moore KL: Clinically Oriented Anatomy 3rd ed. Baltimore, Williams & Wilkins, 1992, p 390.)
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