The "Hand as Foot" teaching method in the anatomy of the ankle joint.

Dear editor,

The spread of the COVID-19 epidemic around the world has left many colleges and universities struggling to meet their expectations. Therefore, a significant improvement in the efficiency and quality of teaching would greatly reduce the impact of the epidemic on global education. So, how can students take in and understand more in a limited amount of time? Traditional teaching methods may need to be improved in light of the current situation. Based on years of clinical practice and teaching experience, “Hand As Foot” teaching method was summarized and proposed, which has been proved effective in many institutions. , In this time, it will be shown that how “Hand As Foot” teaching method works in visualization of ankle ligament.

The ankle contains many irregular bones and many joints involve multiple bones, resulting in a lack of familiarity with its structure. Ankle injuries are also very common and it is difficult to make a timely and accurate judgment on the injury when encountered, often requiring the use of expensive examination like CT and MRI, which in turn may increase the risk of missing the diagnosis. Hand with its flexible characteristics can complete many complex operations, but also can be well applied to teaching. In the teaching process, we make an analogy between the back of the hand and the lateral malleolus (as in Fig. 1 ). The back of the hand is considered as the distal end of the fibula, and the five fingers can be considered as the five ligaments of the lateral malleolus in order: the anterior tibiofibular ligament, the anterior talofibular ligament, the calcaneofibular ligament, the posterior talofibular ligament, and the posterior tibiofibular ligament. A positive drawer test of the ankle indicates damage to the anterior talofibular ligament and the posterior talofibular ligament corresponding to the index finger and ring finger. Similarly, an analogy can be drawn between the palm of the hand and the medial malleolus (as in Fig. 2 ). The palm of the hand is still regarded as a bony structure, and due to the wider and thicker characteristics of the ligament of the medial malleolus, the four gaps between the (open) fingers are regarded as four parts of the deltoid ligament: anterior tibiotalar part, tibionavicular part, tibiocalcaneal part and posterior tibiotalar part, respectively, and the fanned out feature of the ligaments is also simulated. The comparison of the two figures helps us to distinguish the structural features between the medial and lateral malleolus and also explains why ankle sprain occurs more frequently in the lateral malleolus. Students showed great interest and joined in the “dancing” crowd. Using this method, we were able to make the complex structure of the ankle joint very clear with one hand, which significantly improved the efficiency and effectiveness of the lesson.

Fig. 1

Analogy between the back of the hand and the lateral malleolus.

Fig. 2

Analogy between the palm of the hand and the medial malleolus.

“Hand As Foot” teaching method has been used in many disciplines and fields, and has been proved to have a good effect in practice, which is worthy of extensive promotion.

Declaration of competing interest

All authors have no potential financial and non-potential financial conflicts of interest.