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About This File

This model is the right lower extremity bone rendering of a 65-year-old male with left thigh myxoid fibrosarcoma. At the time of diagnosis, the patient had metastases to his lungs. The patient therefore underwent neoadjuvant radiotherapy, surgery, and adjuvant chemotherapy and was found to have an intermediate grade lesion at the time of diagnosis. The patient is still living with the metastatic disease at 2.5 years since diagnosis. This is an STL file created from DICOM images of his CT scan which may be used for 3D printing.

 

The leg includes the area between the knee and the ankle and houses the tibia and fibula.  The proximal tibia includes the medial plateau (which is concave) and the lateral plateau (which is convex). The Proximal tibia has a 7-10 degree posterior slope. The tibial tuberosity is located on the anterior proximal tibia, which is where the patellar tendon attaches.  On the anteromedial surface of the tibia is Gerdy's tubercle, where the sartorius, gracilis, and semitendinosus attach. The distal tibia creates the superior and medial (plafond and medial malleolus) of the ankle joint.

 

The proximal fibula is the attachment for the posterolateral corner structures of the knee joint. The peroneal nerve wraps around the fibular neck.  The distal fibula is the lateral malleolus and a common site for ankle fractures.

 

The ankle is a hinge (or ginglymus) joint made of the distal tibia (tibial plafond, medial and posterior malleoli) superiorly and medially, the distal fibula (lateral malleolus) laterally and the talus inferiorly. Together, these structures form the ankle “mortise”, which refers to the bony arch. Normal range of motion is 20 degrees dorsiflexion and 50 degrees plantarflexion. Stability is provided by the anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), and posterior talofibular ligament (PTFL) laterally, and the superficial and deep deltoid ligaments medially. The ankle is one of my most common sites of musculoskeletal injury, including ankle fractures and ankle sprains, due to the ability of the joint to invert and evert. The most common ligament involved in the ATFL.

 

The foot is commonly divided into three segments: hindfoot, midfoot, and forefoot. These sections are divided by the transverse tarsal joint (between the talus and calcaneus proximally and navicular and cuboid distally), and the tarsometatarsal joint (between the cuboids and cuneiforms proximally and the metatarsals distally). The first tarsometatarsal joint (medially) is termed the “Lisfranc” joint, and is the site of the Lisfranc injury seen primarily in athletic injuries.

 

This model was created from the file STS_022.




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