blood supply

 Anatomy

Dorsal Columns 

- light touch, vibration & proprioception

- CTLS (cervical fibres central, sacral fibres lateral)

Lateral Corticospinal Tract

- motor tract

Anatomy

Fascicles of long, spiraling bundles

- tenocytes & Type I collagen

- synovial cells & fibroblasts present

Endotenon 

- surrounds the individual collagen bundles

Epitenon

- fine fibrous outer layer, highly cellular, continuous with endotenon

- contains most of the blood vessels & capillaries

Epidemiology

Second most common  hindfoot after calcaneal fractures

Aetiology

Aviators Astragalus

Fall from height

- hyper-dorsiflexion injury

- neck of talus strikes the anterior tibia

Anatomy

More than half surface covered by articular cartilage

- medial articular wall straight

- lateral articular wall curves posteriorly

Mechanism of Injuries

Rotational force incurred while joint partially flexed & extending

- caught between femoral & tibial condyles

- usually valgus & ER / varus & IR

Anatomy

3 Sesamoids may be present in great toe

- 2 almost always present on plantar aspect of MTPJ

- 1 may be present on plantar aspect of IPJ

MTPJ sesamoids most important

- embedded in FHB tendons

- held together by intersesamoid ligament & plantar plate

- each side of crista / inter-sesamoid ridge

- articulate with plantar facets of 1st MT

Tibial usually larger than fibula

Definition

Complete Lesion 

- bulbocavernosus reflex present 

- no cord function below lesion

- very poor prognosis for recovery

Incomplete Lesion

- bulbocavernosus reflex present

- some cord function below lesion

- good prognosis for recovery

Anatomy

Vertebral Canal narrowest at T8/9

- Also area of vascular watershed