Foot and ankle Flashcards
What is hallux valgus
bony growth of first metatarsal head leading to an abnormal angle of the big toe
What is hallux valgus caused by
tight fitting shoes
more common in women due to heels
How is hallux valgus treated
via surgery
- can remove head of metatarsal and realign
- only done if symptomatic
Advise appropriate footwear
What is hallux rigidus
Essentially OA of the big toe
it causes stiffness of the big toe
What are the features of OA on xray
Osteophytes
loss of joint space
subchondral sclerosis
subchondral cysts
What is the treatment for hallux rigidus
remove osteophytes remove joint fuse joint Realign Replace
What is pes planus
It is the collapse of the medial longitudinal arch of the foot causing a flat foot
How does pes planus present?
Valgus positioning of the heel when standing
pronation of the midfoot (modfoot turns inwards)
Valgus position of the forefoot when standing
When does pes planus become a problem
When it is new, unilateral or causing foot pain
When are xrays necessary in an ankle injury
if pain is in the malleolar zone AND
- inability to weight bear for 4 steps
- tenderness over distal tibia
- bony tenderness of distal fibula
When is an ankle fracture considered stable
If the ankle joint is not displaced
only one malleolus has been fractured - ankle retains two points of articulation
Where is the fracture in a Weber A fracture
Fibular fracture below the syndesmosis
- syndesmosis in tact
- medial malleolus often fracturd
usually stable - can reduce and immobilise in a cast
Where is the fracture in a Weber B fracture
Fibular fracture at the level of the syndesmosis
Syndesmosis may be damaged but does not lead to widening of the tibiofibular articulation
Joint is unlikely to be stable may need ORIF
Where is the fracture in a Weber C fracture
Fibular fracture above the syndesmosis indicating a rupture of the syndesmosis
- widening of the tiiofibular articulation due to syndesmosis damage
- always an unstable fracture - ORIF
internal fixation necessary
