足踝临床生物力学治疗与评估-蔡永裕.pdf

足踝臨床生物力學治療與評估 蔡永裕, MS, PT 台中澄清醫院 復健治療部 主任 中國醫藥大學 臨床副教授 昆明醫大 客座教授 陽明大學 高等治療學與手法治療學 講座講師 台灣衛生福利部與教育部 評鑑委員 美國Northwestern University 骨科碩士 澳洲 Vasylimedical 足踝醫療顧問 鼎足而三 前足 中足 後足 Medial Side Lateral Side:  Functionally, all the articulations act as one structure. 1. Chopart’s joint (Transverse tarsal) : between posterior segment (talus and calcaneus) and mi le segment (navicular and cuboid) 2. Lisfranc’s joint (tarsometatarsal ): between mi le and anterior segment. Ottawa-Buffalo Ankle guidelines: X-ray or not •Cannot bear weight for four steps (two steps on each foot) •Have tenderness over the distal 6 cm of the mid third of the distal tibia or fibula. (A B) •Have point tenderness over the base of the 5th metatarsus (C). •Have point tenderness over the navicular (D). 3 Arches •Medial Longitudinal Arch: – absorbs the majority of the shock of impact – calcaneus, talus, navicular, cuneiforms, and the first (3) metatarsals. •Lateral Longitudinal Arch: – calcaneus, cuboid, and the fourth and fifth metatarsals. •Transverse Arch: – cuneiforms, the cubo