Foot and Ankle Flashcards
What is hallux valgus?
deformity of big toe
caused by medial deviation of 1st metatarsal and lateral deviation of toe itself
Is hallux valgus commoner in males or females?
females
Is hallux valgus commoner in RA?
yes
What is the inflamed bursa over the medial 1st metatarsal head called?
bunion
Treatment of hallux valgus?
better footwear
osteotomy to realign bones
What is hallux rigidus?
OA of first MTPJ
Conservative treatment of hallux rigidus?
wearing stiff soled shoes/metal bar in sole
What is the gold standard of surgery of hallux rigidus?
arthrodesis
What does arthrodesis prevent for women?
high heel wearing
Name the condition where plantar interdigital nerves become subjected to repeated trauma, causing them to become inflamed and swollen, forming a neuroma?
Morton’s neuroma
What do patient’s complain of in Morton’s neuroma?
burning pain
tingling radiating into toes
Who are more likely to get Morton’s neuroma and what is a cause?
women
high heels
Where is Morton’s neuroma found?
between 3rd and 4rth toes
What may clinical examination of Morton’s neuroma reveal?
loss of sensation in affected web space
compression of metatarsal heads may produce click
Conservative managemtn of Morton’s neuroma?
metatarsal pad/offloading sole
steroid/anaesthetics for symptom control
What may be used to diagnose Mrton’s neuroma?
ultrasound to demonstrate swollen nerve
What can cause tendonitis of the Achilles tendon?
repetitive strain from sports
Which drugs may predispose to tendonitis.
Quinolones
Treatment for tendonitis of the Achilles tendon?
rest, physio, use of heel raise
usually self limiting
Should steroids be injected in tendonitis of Achilles tendon#?
no, risk of rupture
What kind of pain occurs in tendon rupture?
sudden, like being shot
What is Simmonds test?
checking to see if plantarflexion of foot is seen whaen squeezing the calk
What is plantar fasciitis?
pain felt with walking at origin of aponeurosis on distal plantar aspect of calcaneal tuberosity
Is flat foot normaly?
can be a normal variation affecting up to 20% of population where medial arch does not develop in childhood
What can cause acquired flat foot?
tibialis posterior tendon injury, RA or diabetes with Charcot foot
Where does the tibialis posterior tendon insert predominantly onto?
medial navicular, serves to support medial arch
How should tibialis posterior tendonitis be treated?
splint with medial arch support to avoid rupture
What is pes cavus?
abnormally high arch of foot
What often accompanies pes cavus?
claw toes
Why do claw and hammer toes occur?
acquired imbalance between flexor and extensor tendons
What can prevent skin problems in claw/hammer toes?
toe sleeves/corn plasters
