Ankle specialist in Mumbai

Bones of the Ankle

The main role of the ankle joint is to connect the leg with the foot and comprises three bones, namely the tibia, fibula, and talus. The tibia (shinbone) and fibula (calf bone) are bones of the lower leg that fuse with the talus, the ankle bone, thereby making the up and down movement of the foot possible.

There are three bony bumps present at the end of the tibia and fibula that participate in forming the ankle joint. These are as follows:

• Medial malleolus :This bony bump is formed by the tibia and is found on the inner side of the ankle.
• Posterior malleolus : As suggested by the name, it is found at the back of the ankle. It is also formed by the tibia.
• Lateral malleolus: It is formed by the fibula and is present on the outer side of the ankle.

Bones of the Feet

Though the foot acts as a single functional unit, it can be divided into three different parts, the hindfoot, midfoot, and forefoot.

Hindfoot :The hindfoot makes up the ankle and heel and comprises the talus bone and calcaneus or heel bone. The heel bone is the biggest in the foot.

Midfoot : The midfoot is the middle region of the foot that connects the hindfoot to the forefoot. It comprises three different bones: a cuboid bone, a navicular bone, and three cuneiform bones. The navicular bone is present in front of the heel bone, and the cuneiform and cuboid bones are arranged before the navicular bone. These bones are connected together to five metatarsal bones of the forefoot, which form the foot's arch and act as shock absorbers when we walk or run.

Forefoot :Forefoot is also comprised of the toes, also known as digits. The digits are formed by phalanges, three in each toe, except the big toe, which has only two phalanges. In addition, the big toe has two additional tiny round sesamoid bones in the ball of the foot, which helps in the upward and downward movement of the toe.

Ankle and Foot Joint

As already mentioned, there are 33 joints in the ankle and foot. The most important ones are as follows:

• Hinge joints:Hinge joints allow flexion (bending) and extension.
• Gliding joints:These are found in the hindfoot, which allows gliding movements.
• Condyloid joints:These are found in the forefoot and toes, which allow flexion (bending) and extension, and the sideward movements, abduction, and adduction.

The joints of the foot and ankle give support and stability to the body's weight, thereby allowing walking, running, and adapting to uneven ground.

Furthermore, the joint surface of all ankle and foot bones are lined with articular cartilage lines. Articular cartilage is a flexible, thin, tough, and slippery surface that allows easy articulation, increased weight distribution, and shock absorption. The cartilage is lubricated by synovial fluid, which makes the smooth movement of the bones possible.

Soft Tissues of the Ankle and Foot

There are various soft tissues that are responsible for holding our feet and ankle bones in place. Some of them are explained below:

Cartilage It is the flexible, shiny, smooth tissue on the ends of bones and combines to form a joint. Cartilage provides cushioning between the bones and makes smooth movement possible.

Ligaments Ligaments are a group of muscular tissues that connect bones to other bones and keep them in place, thereby making the joints stable. The largest ligament in the foot is the plantar fascia, which originates from the heel bone and extends across the forefoot. It travels along the bottom surface of the foot and maintains a curve shape of the foot. Moreover, the plantar fascia ligament stretches and contracts to provide balance and strength to the foot. In addition, lateral ligaments on the outside of the foot and medial ligaments on the inside provide support and stability and permit the up and down movement of the foot.

Any injury to these ligaments can result in joint instability. Our ankle specialist in Mumbai frequently performs ankle joint repair and replacement surgeries to treat such complex ligament injuries.

Muscles

There are 20 muscles that make up the foot. The most important muscles are:

• Anterior tibial muscle: It allows up and down movement of the foot.
• Posterior tibial muscle: This muscle supports the curve.
• Peroneal tibial muscle : It regulates the movement on the outer side of the ankle.
• Extensors: Extensors allows the ankle to lift the toes while stepping forward.
• Flexors: Flexors provide stability to the toes against the floor.

In addition to these muscles, smaller muscles are also present in the foot to help the toes curl and lift.

Tendons

Tendons are the groups of connective tissue fibers that connect muscles to bones. According to our ankle specialist in Mumbai, the Achilles is the biggest and strongest tendon in the foot that is present at the posterior of the lower leg on the sides of the heel bone. Some other tendons include peroneal and anterior and posterior tibialis.