Adult foot & ankle problems Flashcards
what is hallux Valgus?
Medial deviation of the first metatarsal and lateral deviation of the toe
Is hallux valgus more common in males or females?
females
A female presents with a widened forefoot and the medial part of her foot is rubbing on her shoes. What is the likely differential diagnosis?
Hallux valgus
What is the conservative management of hallux valgus?
What is the surgery of choice for hallux valgus and when is it indicated?
Wider and deeper shoes to reduce rubbing
Multiple osteotomies to realign the bones - indicated when there is pain/lifestyle limitations. NOT recommended for cosmetics bc patients often still unhappy with the appearance after surgery
What is plantar fasciitis?
Pain in the instep of the foot and at the insertion of the plantar aponeurosis on the calcaneal tuberosity
What can cause plantar fasciitis?
excessive exercise - marching, lots of walking if not used to it, dancing etc
walking on hard floors
Obesity
Diabetes - cause unknown but more common in diabetics
Management of plantar faciitis?
rest and stretches
gel heel pad
steroid injections
What is hallux rigidus?
OA of the 1st MTP joint (big toe) - slow progressive pain on movement
What is the gold standard surgical management of hallux rigidus?
Arthrodesis - surgical fusion
Which metatarsals are most likely to be affected by stress fractures and how are they managed?
most common in 2nd metatarsal, then 3rd
Rest for 6-12 weeks - won’t show up on X-Ray for a few weeks until callus forms
What is Morton’s Neuroma?
When plantar interdigital nerves become swollen and inflamed due to irritation and form a neuroma
What can cause Mortons neuroma?
Wearing high heels
which interspace nerve is most commonly affected by Mortons neuroma?
3rd most common, then 2nd
Typical presentation of Mortons Neuroma?
Burning/tingling sensation in the toes
Loss of sensation in the affected webspace
Positive Mulder’s click test
Which form of imaging can aid diagnosis of Mortons neuroma?
Ultrasound - will show a swollen nerve
