2) Foot & Ankle Pathologies Flashcards
What are some causes of foot/ankle pathologies?
Fx OA & Deformities Tendon/Ligament Disorders Nerve Problems Neuromuscular Disorders Heel Pain Tumors Infections Sensory Deficits
What is the tx for isolated lateral malleolus fx?
Immobilization for 6wks, WBAT
What is the tx for bimalleolar & trimalleolar fx’s?
ORIF
What is the tx for bimalleolar equivalent fx w/ruptured deltoid ligament?
ORIF
What is the tx for pilon (distal tib-fib) fx or shattered ankle?
ORIF
What is the tx for open fx’s?
1) Pulsed lavage to sanitize
2) Test for dead muscle
3) IV antibiotics
What are the 4 C’s?
Color, Consistency, Contractility, & Capacity to bleed
Why are syndesmotic screws not the best?
They’re left in place, so during movement they can heat up & break
What is osteochondral defect (OCD) & how is it tx’ed?
Divot that can form in the ankle after injury
Tx’ed w/arthroscopy or OATS to transplant cartilage
What is a Hoffman Procedure?
Standard procedure for RA where met head is removed
Seronegative Arthritis
Lupus, Soriatic Arthritis, Chrohn’s Disease
Septic Arthritis
Infection in the jt
UCBL Brace
Controls hindfoot motion
What is hallux rigidis & what is the tx?
Bone spur on the dorsal aspect of the foot
Tx: Put pt in a rigid sneaker or carbon fiber insole w/morton’s extension
Are total ankle arthroplasties a thing?
Yes, but they come w/a lot of complications
Halux Valgus
Abn prominence at the medial aspect of the MTP of the big toe
Who is more likely to get hallux valgus and why?
Women; Their footwear
Normal 1st MTP Angle
Normal 1st & 2nd Intermetatarsal Angle
MTP=<15°
InterMet>9°
How is hallux valgus tx’ed?
Pt ed about proper footwear
Shoe Modification
Silicon Pads
Bunion Splints
Shoe Fitting Guidelines
- Stand while being fitted
- Don’t buy shoes that are too tight
- Limit heel height to 2”
- Don’t assume the shoe will fit
- Get a shoe that conforms to the shape of your foot
- Fit shoes to the larger foot
- Buy shoes at the end of the day when feet are largest
Peroneal Nerve Palsy
Foot drop as the result of knicking the peroneal nerve during surgery
Reflex Sympathetic Dystrophy (CRPS)
Extreme sensitivity to even light touch
Plantar Fasciitis
Inflammation of the plantar fascia, especially right off the origin; Typically occurs in middle-aged pt’s
What is the most common foot & ankle problem?
Plantar Fasciitis
Risk factors for plantar fasciitis
Obesity
Prolonged Standing
Distance runners w/cavus feet
Systemic Diseases
What does a physical exam that’s (+) for plantar fasciitis show?
Tenderness over plantar fascia origin
How is plantar fasciitis tx’ed?
Stretching Relative Rest Well-cushioned shoes Silicon heel cushion NSAIDS Night Splints Casting
What are cortisone shots not recommended for plantar fasciitis?
It can cause fat pad atrophy which can lead to plantar fascia tear
When is surgical release for plantar fasciitis done?
After 6mo of failed tx
Complications of plantar fasciitis release surgery:
- Loss of arch
- Lateral foot pain
- Nerve injury
- Recurrent heel pain
Risk factors of insensate foot:
- Alcoholism
- Syphilis
- Leprosy
- Syringomyelia
- Beriberi
- Pesticides
- Meds
- Heavy Metals
- Endocrine Disorders
