REIDER PART 2
13

Chaptek 7_Lower Leg, Foot, and Ankle 273

In this position, thc examiner grasps the patient’s heel and gently iiwerts it and everts it as far as possible. The amount of motion is asscssed by estimating the angle between a linę bisccting the heel and another linę bisect-ing the posterior leg (Fig. 7-39). Average eversion is about 20^u and inversion about 40°, although consider-able variation exists in the normal population. Severe restriction or absence of subtalar motion in a child or adolescent suggests the possibility of tarsal coalition; in an older individual, it is the common seąuela of hindfoot fractures, particularly those involving the calcaneus.

Forefoot

Abduction and Adduction. Forefoot abduction and adduction are usually evaluated by passively stabilizing the calcaneus in neutral position with one hand and pushing the forefoot laterally and medially, respec-tively, with the other hand (Fig. 7-40). The transverse tarsal joints are responsible for the smali amount of motion that exists. This motion totals about 5° in most individuals. Clinically, it is sufficient to document that motion is present because it is very difficult to measure accurately.