Foot and Ankle Problems Flashcards
what is hallux valgus?
a deformity of the first toe
it is laterally deviated
what is hallux valgus often associated with?
pathology in other toes
who is commonly affected by hallux valgus?
elderly individuals
more common in women
what are three common causes of hallux valgus?
familial
hypermobility
RA
is conservative management useful in hallux valgus?
not really
what conservative management can be done for hallux valgus? (4)
analgesia
orthotics
well fitting shoes
physiotherapy
what is the definitive management for hallux valgus?
surgery
what is morton’s neuroma?
a benign fibrotic thickening of a plantar digital nerve due to irritation
what causes morton’s neuroma?
a degenerative process
what is the mean age for morton’s neuroma?
45-50
what is a risk factor for morton’s neuroma?
obesity
who is more commonly affected by morton’s neuroma and why?
women
associated with wearing high heels
how does morton’s neuroma present?
painful forefoot that is exacerbate dby footwear
what is the diagnostic investigation for morton’s neuroma?
ultrasound
what is the conservative management for morton’s neuroma?
weight loss
stretching
better footwear
activity modifications
what is the medical management for morton’s neuroma?
corticosteroid injections (USS guided)
when is surgery done for morton’s neuroma?
conservative management unsuccessful for 2-3 months
inadequate response to corticosteroids
what is the most common cause of acquired flat foot deformity in adults?
tibialis posterior dysfunction
how does tibialis posterior dysfunction present?
pain over the medial malleolus
changes in foot shape
diminished walking ability
what are four treatment options for tibialis posterior dysfunction?
physio
insoles
orthosis
surgery
what should NOT be given for tibialis posterior dysfunction?
steroid injections
what usually causes pes cavus?
idiopathic
describe the pain in plantar fasciitis
pain that starts after rest
can be worse after exercise
besides pain, what else can be seen in plantar fasciitis?
swelling of the heel
tenderness over the heel
what clinical test is done for plantar fasciitis?
tinel’s test positive for baxter’s nerve
how long does it take for plantar fasciitis to get better itself?
18-24 months
what are four conservative management options for plantar fasciitis?
NSAIDs
splints
physio
steroid injections
what causes an achilles tendon rupture?
sudden deceleration with resisted calf contraction
what clinical test is done for achilles tendon rupture?
simmond’s test
will be positive
what ligament is most commonly damaged in ankle instability?
ATFL
what are the three grades of ankle ligament injury from best to worst?
microscopic tear
partial tear
complete tear
when is ankle instability chronic?
> 6/12
recurrent
giving way
what are the three management options for chronic ankle instability?
physio
arthroscopy for pain
reconstruction if needed
what is hallux rigidus?
a painful first MTPJ with stiffness
what is the first line management for hallux rigidus?
weight loss
footwear advice
analgesia
activity modifications
what is the second line management for hallux rigidus?
orthosis
surgery
how are ankle fractures classified?
weber classification
what are the possible complications of a pilon fracture?
infection
nonunion
OA
what causes 5th metatarsal fractures?
inversion injuries
what is a Lisfranc fracture?
a tarsometarasal fracture dislocation
how is a Lisfranc fracture managed?
surgical fixation
what is a possible complication of a Lisfranc fracture?
OA later in life
what causes calcaneus fractures?
a fall from a height
what is there a risk of in calcaneus fractures?
compartment syndrome
what can cause a talus fracture?
forced dorsiflexion
rapid deceleration
what are some possible complications of a talus fracture?
AVN
OA
