16-year-old male presents with lateral knee pain...

in medical •  7 years ago  (edited)

A 16-year-old male presents with lateral knee pain. Structural examination reveals an anterior fibular head somatic dysfunction. Which of the following physical exam findings are consistent with this diagnosis?

  1. Distal fibula is anterior and resists posterior springing
  2. Proximal fibular head resists anterior springing
  3. Talus externally rotated causing the foot to evert and dorsiflex
  4. Talus externally rotated causing the foot to invert and plantarflex
  5. Talus internally rotated causing the foot to invert and plantarflex

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Talus externally rotated causing the foot to EVERT and DORSIFLEX


The physical examination findings of an anterior fibular head somatic dysfunction include:

  • a proximal fibular head that resists posterior spring
  • the distal fibula may be posterior, and the talus is externally rotated causing the foot to evert and dorsiflex.
  • The fibular head glides
    • anteriorly with pronation (dorsiflexion, eversion, and abduction) of the ankle
    • posteriorly with supination (plantarflexion, inversion, and adduction) of the ankle.

When the proximal portion of the fibula (fibular head) is "stuck" either in anterior or posterior the distal fibula will be "stuck" in the opposite motion (e.g. an anterior fibular head will have a posterior distal fibula).

When the distal fibula is posterior the talus will prefer external rotation. This external rotation causes the foot to prefer eversion and dorsiflexion.

Conversely, when the distal fibula is anterior, the talus will prefer internal rotation causing the foot to prefer inversion and plantarflexion.

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