Adult Foot and Ankle Disorders Flashcards
Mr F Harrold
what is the most common foot and ankle pathology?
Hallux Valgus
the eye doesn’t see what…
the mind doesn’t know
name the 3 rockers in the gait of the foot
1st Rocker - Heel strike to flat foot
2nd Rocker - Mid stance
3rd Rocker - Heel rise
Pes Planus is a normal varient associated with ligamentous laxity
true or false?
true
what is the most common cause of acquired flatfoot deformity in adults?
tibialis posterior dysfunction
what is the course of tibialis posterior dysfunction?
immediately posterior to medial malleolus
attaches on to navicular tuberosity and plantar aspect of medial and middle cuneiforms
primary dynamic stabiliser of medial longitudinal arch – elevates arch
invertor & plantar-flexor
in whom is tibialis posterior dysfunction common in?
obese middle aged female flat foot hypertension diabetes steroids
what is sign of tibialis posterior dysfunction?
Pain and/or swelling posterior to medial malleolus – very specific
how many types of TPD are there?
I, II, III, IV
what is the treatment in TPD?
physiotherapy
insole
footwear
surgery
what is Pes Cavus?
claw foot
what is plantar fasciitis?
tenderness over plantar aspect of heel and/or plantarmedial aspect of heel
fullness or swelling plantarmedial aspect of heel
plantar fasciitis is worse after ________.
exercise
pain after rest also
what are the causes of plantar fasciitis?
physical overload - exercise or weight seronegative arthropathy diabetes abnormal foot shape improper footwear?
what is the treatment in plantar fasciitis?
NSAIDs night splints taping heel cups physiotherapy injection steroid surgery - 50/50
the best treatment of plantar fasciitis is…
self management
self limiting over 18-24 months
what is Hallus Valgus?
deformity of 1st MTPJ - bunion
what is the incidence of Hallus Valgus?
increases with age bilateral 3F > 1M adolescence RA
what is Hallux Rigidus?
osteoarthritis of 1st MTPJ
what is the management in Hallux Rigidus?
Non-operative
Operative:
- Joint replacement
- Fusion (arthrodesis)
great success rates
RA effects the feet in __% or cases
90%
what foot condition is seen in diabetic patients?
Charcot’s
what does Charcot’s do?
melts the bone
what is Mortons’s neuroma?
degenerative fibrosis of digital nerve near it’s bifurcation
what is the most common part of the foot where pain is experienced in Mortons’s neuroma?
forefoot (metatarsalgia)
what is the mean age of Mortons’s neuroma? what sex?
45-50
female
what is the management in Mortons’s neuroma?
non-operative = insoles and injections
operative = excise
what is tendon-achilles tendinosis?
repetitive microtrauma, failure of collagen repair with loss of fibre alignment/structure
in what age does tendo-achilles rupture occur in?
over 40 with pre existing tendiosis
what are the clinical signs of tendo-achilles rupture?
unable to bear weight
weak plantar flexion
positive calf squeeze (Simmonds) test
what causes ankle sprains?
twisting forces - inversion on planted foot
ankle sprains take ______ to resolve than fracture
longer
Brostrum Gould and Chrisman Snook are the _________ management of ankle sprains
operative
what is the classification of ankle fractures?
Weber A, B, C
Distal fibula fracture with no medial malleolus fracture or deltoid ligament rupture
stable or unstable ankle fracture?
stable
Distal fibula fracture WITH medial malleolus fracture or deltoid ligament rupture
stable or unstable ankle fracture?
unstable
what are Pilon fractures and what causes them?
a fracture of the distal part of the tibia, involving its articular surface at the ankle joint
high energy like falls and road traffic accidents
a Jones fracture is a fracture of what?
the base and middle part of the fifth metatarsal of the foot
what is a Lisfranc injury?
injury of the foot in which one or more of the metatarsal bones are displaced from the tarsus
calcaneus fractures are caused by that?
fall from height on feet
