Foot and Ankle Pathologies Flashcards
What is hallux valgus
Big toe deviates laterally at MTP joint, secondary OA common
Pressure against shoe leads to bunion formation
Hallux valgus treatment
Educate pt on wide low-heeled shoes + foot exercises to strengthen muscles around MTP
Bunion pads + plastic wedges between toes may help to relieve pain
Surgery only if painful bunions which inhibit lifestyle
What is hammer toe
Extended at MTP, hyperflexed at PIP + extended at DIP
Associated with contracture of flexor digitorum longus tendon
2nd toe most commonly affected
What is claw toe
Extended MTP, flexed PIP + DIP
Hammer toe + claw toe treatment
Metatarsal shortening (flexible deformity) PIP joint arthrodesis (fixed deformity)
What is mallet toe
Flexion deformity of DIP in isolation
Mallet toe treatment
Treated with flexor tenotomy (flexible deformity)
DIP joint arthrodesis (fixed deformity)
Onychocryptosis causes
Ingrown toenails typically in big toe of young adults
Incorrect nail cutting ± pressure of shoes
Onychocryptosis treatment
Cotton wool soaked in surgical spirit under infected flesh (proudflesh) and awaiting nail growth
Whole-nail avulsion/wedge resection of affected side more effective in preventing recurrence, especially with phenol
Metatarsalgia causes
Increased pressure on metatarsal head causes pain in ball of foot Heavy, high heels, high-impact sports Inflammatory arthritis Toe deformities Morton's (interdigital) neuroma
Metatarsalgia treatment
OT referral
Orthotics, rest + gentle strengthening
Surgery only RA
March fractures
Shaft of 2nd/3rd metatarsals
May follow excessive walking, radionuclide bone scans more discriminating than xray
Heel pain causes
Calcaneum disease/trauma Calcaneal tendon rupture Postcalcaneal bursitis Arthritis of subtalar Systemic disease/infection Seronegative spondylarthropathy
Plantar fasciitis treatment
Not actually inflammatory, encourage pt to keep mobile but don’t overuse
