adult foot and ankle disorders - 25/10/18 Flashcards
what is pes planus?
Flat feet
What % of the population have pes planus?
20%
What is associated with pes planus?
ligamentous laxity
What is the most common cause of aquired flatfoot deformity in adults?
Tibialis Posterior Dysfunction
When does a foot arch normally appear?
6-7
Where does the tibialis posterior run?
Posterior to medial malleolus
Attaches to navicular tuberosity and plantar aspect of medial and middle cuneiforms
What is the function of the tibialis posterior?
Primary dynamic stabiliser of medical longitudinal arch
Invert and Plantar flex
What are the characteristics of TP dysfunction?
Obese Middle aged Female Flat foot Hypertension Diabetes Steroids Seronegative Pain Swelling Diminished walking Hallux valgus Impingement pain Midfoot and ankle pain
How is TPD treated?
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
What causes pes cavus?
Idiopathic Neurological HSMN CP Polio Spina bifida Club foot
How is pes cavus treated?
Surgery if complec
What are the characteristics of plantar fasciitis?
Start up pain after rest Can be worse after exercise Fullness or swelling Tenderness Tinels + Heel spurs Heel pad pain syndrome
What causes plantar fasciitis?
Physical overload Overweight Overexercise Diabetes Seronegative arthropathies Abnormal foot shape Improper footwear
How is plantar fasciitis treated?
NSAIDs Night splints Taping Heel cups Physiotherapy Steroid inhection ECSWL Surgery Self-limiting
What is hallux valgus?
Deformity at the 1st MTP joint
Big toe deviates laterally
Bunion