footankle

The foot-ankle complex forms the distal segment of the lower limb and supports weight, balance, and forward progression. The foot contains 26 bones: the hindfoot (talus and calcaneus), the midfoot (navicular, cuboid, and the three cuneiforms), and the forefoot (metatarsals and phalanges). The ankle region includes the talocrural joint, formed by the tibia, fibula, and talus, which mainly allows dorsiflexion and plantarflexion, and the subtalar joint between the talus and calcaneus, which enables inversion and eversion. The arches of the foot — medial, lateral, and transverse — help distribute load and absorb shock. Support comes from ligaments such as the deltoid and the lateral ligaments (anterior talofibular, calcaneofibular, posterior talofibular), plantar ligaments, and the plantar fascia, supplemented by intrinsic foot muscles and their tendons and the extrinsic muscles from the leg.

Biomechanically, the foot-ankle complex acts as a flexible adapter during stance and a rigid lever during push-off in gait. Proper alignment and function depend on tendon integrity, muscle strength, and neural input from the tibial and peroneal nerves. Common conditions include ankle sprains and fractures, Achilles tendinopathy, plantar fasciitis, flatfoot deformity, hallux valgus, metatarsalgia, and tarsal tunnel syndrome. Diagnostic evaluation combines history and examination with imaging; standard practice uses weight-bearing X-rays, with MRI or CT as needed for soft tissue or complex injuries.

Management ranges from conservative measures—rest, ice, compression, elevation, NSAIDs, orthotics, and physical therapy—to immobilization or bracing. Persistent symptoms may require surgical repair of ligaments or tendons, fracture fixation, or reconstructive procedures. Rehabilitation emphasizes gradual loading, range of motion, strength, proprioception, and a safe return-to-activity plan. Pediatric considerations include conditions such as tarsal coalitions and flexible flatfoot, which may require observation or intervention guided by symptoms and mobility.