482 



THE INFERIOR EXTREMITY 



passes transversely from a depression on the medial aspect of 

 the lateral malleolus to the posterior process (tubercle) of the 

 talus (Fig. 143). 



The Distal Tibio-Fibular Joint is usually a syndesmosis 



and permits of practic- 

 ally no movement. The 

 two bones are connected 

 by a strong interrosseous 

 ligament and by the 

 inferior transverse liga- 

 ment, which extends 

 from the depression on 

 the posterior part of 

 the medial surface of the 

 lateral malleolus to the 

 posterior border of 

 the distal extremity of 

 the tibia. Occasionally, 

 however, there is a 

 joint-cavity, which com- 

 municates freely with 

 the cavity of the ankle- 

 joint. 



Anastomosis round 

 the Ankle. An import- 



FIG. 143. Frontal Section through the Ankle- 

 joint, the Tibio-Fibular Syndesmosis, the ant anastomosis OCCUrs 

 Talo-Calcaneal and the Talo-Calcaneo- ,, r ,, 



in the region of the 



Navicular Joints. The deltoid ligament, m L1J f , 



on the medial side, and the posterior talo- ankle-joint. Around the 



fibular and the calcaneo-fibular ligaments, lateral malleolus the ter- 

 on the lateral side are shown in the section. 7 -, , f .. 



The strong interosseous talo-calcaneanliga- mmal and Pirating 



ment is seen forming the lateral boundary branches of the peroneal 



of the joint between the head of the talus anastomose with the 

 and the sustentaculum tali. The positions 

 of the distal epiphyseal lines of the tibia 

 and fibula should be observed. 



lateral malleolar branch 

 of the anterior tibial 

 and the lateral tarsal 

 branch of the dorsalis 

 pedis. On the medial 

 side of the ankle the 

 medial malleolar branch of the anterior tibial anastomoses with 

 the medial calcanean branches of the lateral plantar artery. 



Spread of Tuberculous Disease in the Ankle Region. 

 When tuberculous disease originates in the distal end of the 



Light blue = articular cartilage. 

 Striped blue = ligaments. 

 Green = periosteum. 

 Red = synovial membrane. 



