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INTRODUCTION

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To start our review of common foot and ankle problems, we begin with some basic anatomy. There are many bones in the foot, and there is no need to memorize the names of all of them, but it is helpful to know the names of the groups of bones (Figures 5-1,5-2,5-3,5-4,5-5,5-6). From distal to proximal, we start with the phalanges, the bones in our toes. Each toe has a distal, a middle, and a proximal phalanx, except the big toe, which only has a distal and a proximal phalanx. Just proximal to the phalanges is the second group of foot bones, the long, slender metatarsal bones. The metatarsals and phalanges account for what is often referred to as the forefoot. Just proximal to the metatarsal bones are a group of small, short bones called the tarsal bones, which make up the midfoot. The hindfoot bones are the talus and the calcaneus, and the talus is the bone that is the “ball” of the ball-and-socket of the ankle. The “socket” of the ankle joint is actually two separate bones. The tibia contributes the roof and the medial sidewall of the socket, and the distal tip of the fibula accounts for the lateral sidewall. At the sidewalls of the ankle joint, the tibia and fibula become a bit thicker and a bit more prominent, creating the hard, bony features of the ankle that we call the medial and lateral malleoli. That’s a grand total of 28 bones in the foot and ankle (not including the two tiny sesamoid bones under the big toe!). It seems intuitive that our hands would have a disproportionately high number of bones in them, given the large array of complex motions they have evolved to perform, but why the skeletal structure of our feet is so complex is harder to understand.

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Figure 5-1.

Skeletal anatomy of the foot and ankle: phalanges.

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Figure 5-2.

Skeletal anatomy of the foot and ankle: metatarsals.

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Figure 5-3.

Skeletal anatomy of the foot and ankle: tarsals.

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Figure 5-4.

Skeletal anatomy of the foot and ankle: calcaneus, talus.

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Figure 5-5.

Skeletal anatomy of the foot and ankle: medial and lateral malleolus.

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Figure 5-6.

Skeletal anatomy of the foot and ankle: tibia, fibula, ankle joint.

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Despite this apparent overabundance of bones, there aren’t any muscles in the foot and ankle that ...

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