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Anatomy

Lower Limb

Question 69 of 180

A 22 year old man has injured his right foot in an ice-skating accident. X-ray demonstrates an inferior displacement of the head of the talus bone, causing loss of the medial arch of the foot. Which of the following structures has most likely been damaged to allow this to happen:

Answer:

The spring ligament (plantar calcaneonavicular ligament) is a broad thick ligament that extends from the calcaneus to the navicular bone. It supports the head of the talus, stabilises the talocalcaneonavicular joint and resists depression of the medial arch of the foot.

Spring Ligament

Anatomy / Lower Limb / Ankle and Foot Joints

Last Updated: 25th January 2019

The spring ligament (plantar calcaneonavicular ligament) is a broad thick ligament that extends from the calcaneus to the navicular bone. It supports the head of the talus, stabilises the talocalcaneonavicular joint and resists depression of the medial arch of the foot. The spring ligament takes the weight of the body from the talus and transmits it to the forefoot.

Modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons

Spring Ligament. (Image modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons)

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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