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Ankle Joint

Ankle Joint

The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...

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Related Experiment Video

Updated: Sep 10, 2025

Predictive Measurement for Windlass Change in Length and Selected Treatment Outcomes in Chronic Plantar Fasciitis

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Can Simple Changes in Splinting Technique Reduce Posterior Heel Contact Pressure?

Erik R Nakken¹, Kempland C Walley¹, Carol A Janney²

¹Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.

Clinical Orthopaedics and Related Research

|August 27, 2025

Summary

Floating the heel with 8-10 layers of padding in lower extremity splints significantly reduces posterior heel pressure. Proper padding application is crucial to prevent pressure ulcers.

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Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication

Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication

Published on: December 11, 2013

Area of Science:

Biomechanics
Orthopedics
Materials Science

Background:

Lower extremity splints are essential for treating foot and ankle injuries.
Posterior heel pressure injuries are a common complication of splinting.
Optimizing splint design can mitigate heel pressure risks.

Purpose of the Study:

To identify splint characteristics that minimize posterior heel contact pressure.
To determine if heel position, padding thickness, and padding type affect heel pressure.
To investigate factors contributing to increased heel pressure during splinting.

Main Methods:

A biomechanical study involving 10 participants and 20 legs.
Utilized a pressure transducer to measure posterior heel contact pressure in short leg splints.
Varied padding layers (0-10), padding brands, and heel position (down vs. floating).

Main Results:

Resting the heel down consistently resulted in pressures above the 32 mm Hg threshold.
Floating the heel with 6-10 layers of thicker padding or 8-10 layers of thinner padding reduced pressure below 32 mm Hg.
Improperly bunched padding increased mean contact pressure threefold.

Conclusions:

Optimal splinting involves floating the heel with 8-10 evenly applied layers of thicker padding.
Floating the heel is a key modifiable factor for reducing dermal pressure.
Attention to splinting details may decrease the incidence of posterior heel pressure ulcers.