Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Combined plantar flexion-eversion

Significance.

This movement stretches all the medial ligaments of the ankle.

Positioning.

The heel rests on the couch, the knee is slightly Aexed and the ankle is in neutral
position. The examiner is distal to the foot. His contralateral hand fixes the leg at the distal and lateral side. The ipSilateral hand encircles the mid foot with the heel lying on the first metatarsal bone and the fingers encircling the lateral border.

Procedure.

Stabilize the leg with the contralateral hand. Press the foot downwards and outwards with the heel of the ipsilateral hand. Meanwhile perform a pronation by an upwards pulling of the fingers.

Common mistakes.

• The lower leg is not stabilized.
• Plantar Aexion is lost.
• Pronation is not performed.
• Painful pinching of the forefoot occurs.

Normal functional anatomy:

• Range: 15-45°
• Elld-feel: ligamentous
• Umiti”g structures:

– anterior part of the deltoid ligament
– calcaneonavicular ligament
– capsules of the medial midtarsal joints
– tendon of the tibialis anterior.

Common pathological situations:

• Medial pain may be caused by a lesion of the anterior portion of the deltoid ligament or by a tendinitis of the tibialis posterior.
• Lateral pain may indicate a painful squeezing of the posterior talofibular ligament.

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