Ankles

The ankles are the joints where the legs meet the feet, consisting of the true ankle joint formed by the tibia, fibula, and talus, and the subtalar joint between the talus and calcaneus. The mortise created by the tibia and fibula holds the talus in place, enabling up-and-down movement, while the subtalar joint allows side-to-side motion.

The main ligaments include the lateral collateral ligaments—the anterior talofibular, calcaneofibular, and posterior talofibular ligaments—and the deltoid ligament on the medial side. The Achilles tendon, formed by the gastrocnemius and soleus tendons, attaches to the calcaneus and acts as the primary plantarflexor. Neurovascular supply mainly comes from branches of the posterior tibial and dorsalis pedis arteries, with innervation from the tibial and common peroneal nerves.

Movement at the ankles enables dorsiflexion and plantarflexion at the tibiotalar joint, and inversion and eversion at the subtalar joint. Stability depends on the bony architecture, the surrounding ligaments, and the action of muscles in the lower leg and foot.

Common injuries and conditions affect the ankles and include sprains (especially lateral), fractures of the malleoli or talus, and Achilles tendon injuries. Chronic instability, osteoarthritis, and tendinopathies are other potential issues. Diagnosis typically relies on history, physical examination, and imaging such as X-rays; MRI or CT may be used for detailed assessment.

Treatment ranges from rest, ice, compression, and elevation to immobilization with a boot or cast, followed by physical therapy. Surgery may be required for severe fractures or persistent instability. Prevention focuses on proper footwear, balance and strengthening exercises, and gradual return to activity after injury.