Foot and ankle orthopaedics Flashcards
what is hallux valgus
medial deviation of the 1st metatarsal and lateral deviation of the toe
what makes hallux valgus more common
female 4x older age familial inflammatory arthropathies RA MS CP
conservative management of hallux valgus
wider, deeper accomodating shoes
spaces in first web space
surgical management of hallux valgus
osteotomies to realign bones
what is hallux rigidus and what is the conservative and surgical management
OA of 1st MTPJ
conservative - stiff sole shoe to limit MTPJ motion, removal of dorsal osteophytes
surgical - arthrodesis
what is the complication for women with surgical arthrodesis of hallux rigidus
cant wear high heels
what is mortons neuroma and who is it more common in
irritation and inflammation fo palmar interdigital nerves to form neuroma
more common in women and in high heel wearing
conservative and surgical management of mortons neuroma
conservative - metatarsal pad, steroid/anaesthetic injection
surgical excision with risk of recurrence and pain
true/false- to check for metatarsal stress fractures get an x ray
false - it might not show for 3 weeks, a bone scan might show faster
whos more likely to get a metatarsal fracture
runners, soldiers on prolonged march, dancer, prolonged walking in the inexperienced
risk factors for achilles tendonitis
ciprofloxacin
gout
RA
inflammatory arthropathies
true/false - manage achilles tendonitis with steriod injection
false - never do
management of achilles tendonitis
rest, physio, heel raise to offload tendon
resistant - decompression/resection
what predisposes achilles tendon rupture
achilles tendonitis
what is simmonds test
no plantarflexion of foot whilst squeezing calf
indicative of achilles tendon rupture
conservative and surgical management of achilles tendon rupture
suture repair with casting for 8 weeks. may cause problems if not healing
casting in equinous position for 8 weeks. closes tendon gap
what is plantar fasciitis and what are the risk factors
self limiting stress with pain on instep, plantar aponeurosis on distal plantar aspect of calcaneal tuberosity diabetes obesity walking on hard floors poor cushioning
managing plantar fasciitis
rest, stretching of achilles and plantar fascia
gel fill heal pad, steriod injection
where is pes planus more common
ligament laxity
familial
what issue may developmental flat footedness cause
tendonitis of tibialis posterior
cause of acquired flat feet
tibialis posterior stretch/rupture
RA
diabetes with charcot foot
what is pes cavus and what causes it
abnormal high arched foot idiopathic CP polio spina bifida hereditary sensory and motor neuropathy
management of pes cavus
soft tissue release, tendon transfer if supple
rigid - calcaneal osteotomy
severe - arthrodesis
claw toes have hyperflexion/hyperextension at MTPJ, hyperflexion/hyperextension at PIPJ and hyperflexion/hyperextension at DIPJ
hyperextension
hyperflexion
hyperflexion
hammer toes have hyperflexion/hyperextension at MTPJ, hyperflexion/hyperextension at PIPJ and hyperflexion/hyperextension at DIPJ
hyperextension
hyperflexion
hyperextension
what issues may arise from claw/hammer toes that can be managed conservatively
skin rubbing
toe sleeves
corn plasters
surgical solutions for claw/hammer toes
tenotomy
tendon transfer
arthrodesis of PIPJ
amputation
what does the tibialis posterior tendon function to do, what is the management for dysfunction
maintains medial arch, plantarflexion, inversion
medial arch splint
surgical decompression, tenosynovectomy
