Flat foot reconstruction (Dr. Feilmeier) Flashcards
What is equinus?
inability to dorsiflex your foot beyond neutral position, get get 10 degrees pass the neutral position without the patient helping
What are some causes of equinus?
- knee bend backwards
- foot pronates. could cause bunion
- could be a misalignment of the hips
Where will a patient have pain for flat foot?
could be both medial and lateral side
- medial side is collapsed and lateral side has to overcompensate
tarsal coalition
two bones that have grown together, creating a rigid foot
Orthotics as conservative treatment for flat foot
it’s a semi rigid device, controls overpronation, but it’s difficult to control transverse plane deformity
Stretching as conservative treatment for flat foot
most minimal long term benefit
Conservative treatment may not be most helpful if…
conservative treatment has limited long term benefits if pathologic and associated with equinus.
- DJD (degenerative joint disease) and chronic changes to bone and tendon will occur if not addressed early
- but conservative treatment should always be offered first over surgical repair
What can surgical intervention achieve?
- address equinus
- calcaneal osteotomies
- midfoot osteotomies
- tendon transfers
- tarsal implant
In regards to the Evans procedure, what does lengthening the lateral column do?
- relocate TN (talonavicular) joint
- preload the plantar fascia
- improve Peroneus longus (tendon) function
In regards to the Evans procedure, what does moving the effective STJ (subtalar joint) axis lateral do?
- medialize Achillies
- increases supination of TA
- enlarge the supinatory level arm GRF (ground reaction force)
- reduce valgus heel
- more effective MTJ (midtarsal and ankle joint) locking
- increase calcaneal inclination
