Ankle and Foo Flashcards
What is Talipes Equinovarus?
Clubfoot
What is the position of the calcaneus with clubfoot?
varus
What is the forefoot position in clubfoot?
adduction
What is the position of the midtarsal in clubfoot?
Supination
What happens to the joint capsule in clubfoot?
thickened
Who gets clubfoot more often?
Males 2:1
How many cases of clubfoot are bilateral?
1/3-1/2
What is the management of eqinovarus?
weekly casting (6 wks) splints (8 wks) AFO or corrective boot (until walking) Night splint (1 more year) Straight lace shoes (2 years)
What % of those with equinovarus respond in the first 3-4 months?
40%
What % of those with equinovarus need soft tissue surgery?
60%, usually a muscle release
If the pt is not treated for equinovarus by 5 years what will they need?
arthrodesis, usually wait until they are > 10 years old
What is pes cavus?
Structural high medial and lateral arch resulting in a rigid foot
What can pes cavus be associated with?
May be associated with a neurological disorder
Is pes cavus familial?
yes
What is an associated pathology with pes cavus?
Claw toes
What is the Rx for pes cavus?
adaptive shoes
specialized arch supports
What is pes planus?
flat feet, congenital or acquired. If you dont have adequate dorsiflexion you will pronate prematurely.
A congenital pes planus is more or less common? more or less rigid?
less common. More rigid
How is pes planus acquired?
compensation for other bony abnormalities, weakness or neuromuscular problems
What is Hallux limitys?
1st MTP restriction usually due to OA or Jt capsule.
How much MTP extension do you need for push off?
65 degrees
What is the Rx for Hallux limitus?
adaptive shoues (rocker sole shoes), joint mobs (if capsular)
What is Hallux rigidus?
complete bony ankylosis, may require resection arthroplasty
What is hallux (abducto)valgus?
1st toe laterally angulated at MTP joint associated with bunion formation
Who gets hallux (abducto)valgus more?
Females>males, usually assocated with poorly fit shoes
What is a Keller operation?
Resection of proximal half of the proximal phalanx and excision of prominent medial portion of met head
What is a hammer toe?
MTP extended, PIP flexed,
How are hammer toes caused?
Intrinsic weakness or imbalances
fallen transverse arch
poor shoe fit
What is a claw toe?
MTP extended, PIP flexed, DIP extended
What is a mallet toe?
Flexed DIP, usually due to poor shoes
What is a mortons toe?
Long 2nd metatarsal or short 1st metatarsal elading to excessive pressure under 2nd met head
What do you see sometimes with a mortons toe?
abnormal pronation
What is Mortons neuroma?
Nerve inflammation usually between 3rd and 4th metatarsals
Who gets mortons neuroma more?
Females>males
What are the symptoms of mortons Neuroma?
burning pain, toe numbness
What is the Rx for Mortons neuroma?
Roomier shoes (limit heels)
Corticosteroid injection
Orthosis
Excision if conservative failure