Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

#2 Surg > 26 - Everted Forefoot Deformities > Flashcards

26 - Everted Forefoot Deformities Flashcards

1
Q

Types of everted forefoot deformities

A
  • Forefoot valgus
  • Plantarflexed 1st ray
  • Dorsiflexed cuboid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Forefoot valgus diagram

A

There are two types – flexible (total) forefoot valgus

(7 degrees) or rigid plantarflexed 1st ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Total forefoot valgus

A
  • Everted position of the forefoot relative to the rearfoot at the level of the MTJ.
  • All of the metatarsals are on the same everted plane with one being more inferior to five
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Possible etiology of total forefoot valgus

A

o Due to excessive frontal plane valgus torsion of the head and neck of the talus. At birth, the head and neck of the talus are in a varus rotation which quickly corrects by undergoing a valgus rotation.
o If the compensation is excessive, the MTJ everts relative to the STJ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Lateral column in total forefoot valgus

A
  • Inversion of the lateral column of the forefoot must occur to allow the forefoot to purchase the ground during midstance and propulsion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

2 forms of compensation

A

o Flexible(total)forefoot valgus (7°)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The compensation for a forefoot valgus follows the acronym LASSO

KNOW THIS

A

o LAS is MTJ longitudinal axis supination – this occurs with the flexible FF valgus
o S is STJ supination and O is MTJ oblique axis supination – These occur with rigid FF valgus (after first undergoing LAS)

LASSO
o	L = longitudinal 
o	A = axis
o	S = supination
o	S = STJ supination
o	O = MTJ oblique axis supination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Flexible (total) forefoot valgus

A
  • Sufficient flexibility exists within the long axis of the MTJ (LMTJ) to equal the degree of FF valgus, and allows the lateral column of the foot to reach the ground.
  • Leads to severe MTJ instability during propulsion even though the heel is vertical in RCSP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

RCSP in flexible (total) forefoot valgus

KNOW THIS

A
  • The heel is vertical in RCSP*
  • In flexible FF valgus, the heel remains vertical (the STJ does not need to compensate for the deformity), but the medial arch drops
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Flexible (total) forefoot valgus compensation details

A
  • All of the compensation occurs around the long axis of the MTJ
  • It is a hypermobile foot because the MTJ is supinated
  • We know that the supinated position of the MTJ is the unstable position of the forefoot (MTJ pronation is the stable position-cuboid locked on dorsal lip of calcaneus)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Signs and symptoms of flexible (total) forefoot valgus in the skin

A

o Medial heel callus
o Callus sub 2 ( 5 degrees)
o Corn 2, 4, 5 toes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Signs and symptoms of flexible (total) forefoot valgus in the muscle and fascia

A

o Posterior tibial strain

o Plantar fasciitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Signs and symptoms of flexible (total) forefoot valgus in the bones

A 
o	Sinus tarsi syndrome
o	Cuboid syndrome
o	1st met - cunei exostosis
o	Bunion
o	Tailor’s bunion
o	Heel spur
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Signs and symptoms of flexible (total) forefoot valgus in the gait

A

o Abductory twist
o Late midstance pronation
o Mild lateral instability may occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Signs and symptoms of flexible (total) forefoot valgus in the foot type

KNOW THIS

A

**Severe flatfoot **

This means there will be strain on the MEDIAL ankle structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Rigid (total) forefoot valgus

A
  • If the amount of FF valgus is > 7 degrees, the LMTJ cannot fully compensate.
  • STJ supination occurs first.
  • If this is insufficient to get the lateral column to the ground, the OMTJ supinates.
17
Q

RCSP in rigid (total) forefoot valgus

KNOW THIS

A

Heel is in varus in RCSP

This leads to a HIGH ARCH

18
Q

Signs and symptoms of rigid (total) forefoot valgus in the skin

A

o Lateral heel callus
o Callus sub 1 & 5
o Corn 4 & 5 toes

LATERAL instability present

19
Q

Signs and symptoms of rigid (total) forefoot valgus in the muscle or fascia

A

o Plantar fasciitis
o Achilles tendonitis
o Functional equinus

20
Q

Signs and symptoms of rigid (total) forefoot valgus in the bones

A 
o	1st met - cunei-exostosis
o	Hallux limitus
o	Increased shock in gait
o	Retrocalcaneal exostosis
o	Heel spur
21
Q

Signs and symptoms of rigid (total) forefoot valgus in the gait

A

o Normal progression

o Resupination at midstance

22
Q

Signs and symptoms of rigid (total) forefoot valgus in the foot type

*KNOW THIS

A

Stable cavus

LATERAL INSTABILITY

23
Q

Two types of deformities seen with a plantarflexed 1st ray

A
  • Structural

- Positional

24
Q

Structural deformity - plantarflexed first ray

KNOW THIS

A
  • AKA rigid plantarflexed 1st ray
  • Congenital
  • Cavus foot
  • Difficult to dorsiflex 1st metatarsal head to level of 2nd metatarsal head with manual pressure with STJ neutral – lesser meta heads are on the same parallel plane
  • 1st ray R.O.M. is normal (10 mm), but more in plantarflexion.
  • RCSP of varus (compensates just like a rigid FF valgus)
25
Q

Foot type in structural plantarflexed 1st ray

KNOW THIS

A

***** Cavus foot **

26
Q

RCSP in structural plantarflexed 1st ray

KNOW THIS

A

RCSP of varus (compensates just like a rigid FF valgus)

27
Q

Positional deformity in plantarflexed 1st ray

A
  • AKA flexible plantarflexed 1st ray
  • Lesser metatarsal heads are in varus
  • Foot type: Mild cavus with vertical calcaneus in RCSP
  • Range of motion
28
Q

Positional plantarflexed 1st ray deformity is acquired due to…

A

Acquired due to:
o Possible compensation for a supinated foot type (partially compensated and uncompensated forefoot varus and rearfoot varus)
o Achilles tendon lengthening or rupture which leads to overactive peroneus longus in assisting with heel off
o Frank spasm of PL (pulling the 1st metatarsal head down)

29
Q

Foot type and RCSP seen in positional 1st ray

KNOW THIS

A

Mild cavus with vertical calcaneus in RCSP*

30
Q

Rigid and flexible plantarflexed 1st metatarsal

A
  • Shares many of the same signs and symptoms as a rigid forefoot valgus – high arch
  • Increased incidence of tibial sesamoid pain and ankle sprains
31
Q

Dorsiflexed cuboid

A
  • Plane of all the metatarsal heads everted to the rearfoot with STJ neutral and MTJ locked.
  • As cuboid dorsiflexes, the 4th and 5th metatarsals are raised above the ground
32
Q

Dorsiflexed cuboid is acquired due to…

A
  • Acquired deformity due to chronic subluxation of the OMTJ from a tight gastroc-soleus complex.
33
Q

Dorsiflexed cuboid is compensated for by…

A
  • Compensation for a gastrosoleus or gastroc equinus is by STJ pronation which unlocks the OMTJ to try and keep the heel on the ground by increasing dorsiflexion at the OMTJ.
  • This causes a dorsiflexion of the forefoot on the rearfoot
  • With the STJ neutral and MTJ locked, the plane of the metatarsal heads will be everted relative to the rearfoot
34
Q

Foot type seen in dorsiflexed cuboid

KNOW THIS

A

Foot type is very flat foot

35
Q

A rigid total forefoot valgus compensates initially by:
o STJ supination
o Supination around the oblique axis of the MTJ
o STJ eversion
o Supination around the long axis of the MTJ
o Dorsiflexion of 1st metatarsal by tibialis anterior

A

Answer: 4

36
Q

The RCSP for an isolated flexible FF valgus deformity is:
o Varus
o Valgus
o vertical

A

Answer: 3

37
Q

A flexible plantarflexed 1st ray is:
o Associated with lesser metatarsals that are all on the same sagittal plane
o A possible compensation for a FF varus
o A possible compensation for a RF valgus.
o Seen with a weakness of the peroneus longus

A

2

38
Q

FOCUS

A
  • Know RCSP (heel) position following compensation

- Know the types of deformities that lead to each compensation and what foot type that leads to

#2 Surg (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions