adult foot and ankle disorders - 25/10/18 Flashcards

1
Q

what is pes planus?

A

Flat feet

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2
Q

What % of the population have pes planus?

A

20%

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3
Q

What is associated with pes planus?

A

ligamentous laxity

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4
Q

What is the most common cause of aquired flatfoot deformity in adults?

A

Tibialis Posterior Dysfunction

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5
Q

When does a foot arch normally appear?

A

6-7

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6
Q

Where does the tibialis posterior run?

A

Posterior to medial malleolus

Attaches to navicular tuberosity and plantar aspect of medial and middle cuneiforms

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7
Q

What is the function of the tibialis posterior?

A

Primary dynamic stabiliser of medical longitudinal arch

Invert and Plantar flex

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8
Q

What are the characteristics of TP dysfunction?

A
Obese
Middle aged
Female
Flat foot
Hypertension
Diabetes
Steroids
Seronegative
Pain
Swelling
Diminished walking
Hallux valgus
Impingement pain
Midfoot and ankle pain
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9
Q

How is TPD treated?

A
Physiotherapy (best for type 1)
Insole
NO steroid injections
(US to check tendon for synovitis, inject into tendon sheath under US guidance)
orthotics
Good footwear
Surgery
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10
Q

What causes pes cavus?

A
Idiopathic
Neurological
HSMN
CP
Polio
Spina bifida
Club foot
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11
Q

How is pes cavus treated?

A

Surgery if complec

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12
Q

What are the characteristics of plantar fasciitis?

A
Start up pain after rest
Can be worse after exercise
Fullness or swelling 
Tenderness
Tinels +
Heel spurs
Heel pad pain syndrome
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13
Q

What causes plantar fasciitis?

A
Physical overload
Overweight
Overexercise
Diabetes
Seronegative arthropathies
Abnormal foot shape
Improper footwear
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14
Q

How is plantar fasciitis treated?

A
NSAIDs
Night splints
Taping
Heel cups
Physiotherapy
Steroid inhection
ECSWL
Surgery 
Self-limiting
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15
Q

What is hallux valgus?

A

Deformity at the 1st MTP joint
Big toe deviates laterally
Bunion

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16
Q

What are the characteristics of hallux valgus?

A
Increases incidence with age
Bilateral
Females
Adolescent subgroup
Familial
Shoes?
Joint laxity
Rheumatoid
Splayed forefoot associated with loss of muscle tone and age
17
Q

What causes pain in bunions?

A
Median nerve
From Bursae
Intrinsic joint pain
(wear and tear)
Non functional big toe
Loading through toes 2-5
18
Q

What are problems with hallux valgus?

A
Transfer metatarsalgia
Lesser toe impingement
Pain
Deformity
Cosmeis
Shoe difficulties
19
Q

How is hallux valgus managed?

A

Non-operative
-Shoe modification
-Padding
Operative

20
Q

What are the indications for hallux valgus operative management?

A
Failure of non-op pain
Lesser toe deformities
Lifestyle limitation
Overlapping
Ulceration
Functional limation