Foot and ankle problems Flashcards
What is compartment syndrome?
Haemorrhage and/or oedema leading to increased intracompartmental pressure caused by trauma to any fascial compartment
What are the signs of compartment syndrome?
- Severe pain
- Pain not relieved by analgesics
- Pain exacerbated by passive stretching
How is compartment syndrome treated?
Surgical decompression (fasciotomy)
What are the possible short term and long term consequences of untreated compartment syndrome
- Decreased perfussion of muscle (S)
- Rhabdomyolysis = muscle necrosis (S)
- Acute kidney injury (S/L)
- Ischaemia to nerve fibres = loss of motor function (L)
- Fibrosis of necrotic muscle tissue = Volkmann’s ischaemic contracture (L)
What is the usual mechanism for an ankle fracture?
Inversion or eversion injury
How are ankle fractures treated?
Stable = aircast boot or fibreglass cast Unstable = surgical stabilisation
What is a sprained ankle?
Partial or complete tear if one or more ligaments of the ankle joint
What factors increases the risk of a sprained ankle?
- Weak muscles/tendons
- Weak or lax ligaments
- Inadequate joint proprioception
- Slow neuromuscular response
- Running on uneven surfaces
- Shoes with inadequate heel support
- High heeled shoes
Why is it common to find a fifth metatarsal fracture with sprained ankle?
Peroneus/fibularis brevis tendon is attached to the tubercles on the base of the 5th metatarsal
What are the signs and symptoms of an achilles tendon rupture?
- Sudden severe pain
- Loud pop sound
- A palpable gap/depression
- Inability to stand on tip toe
What tests can be used to diagnose an achilles tendon rupture?
Thompson’s test (no plantarflexion when pressing calf)
-Can also use MRI and ultrasound to show gap
How are achilles tendon rupture treated?
Surgical reconstitution
Aircast boot
What is hallux valgus?
When the big toe (distal part) is deviated laterally
- Varus deviation of first metatarsal
- Valgus deviation of hallux
What is a hallux rigidus?
Osteoarthritis of the 1st metatarsophalangeal joint
What is arthroplasty?
Joint replacement for osteoarthritis
What is arthrodesis?
Joint fusion for osteoarthritis
What is excision arthroplasty?
Surgical removal of the joint in OA with interposition of soft tissue
What is osteomy?
Surgical cutting of a bone to allow realignment
What are the 4 types of toe deformities affecting the 2nd to 5th toes?
- Claw toe (hyperextended MTPJ and flexed PIPJ)
- Hammer toe (flexed PIPJ)
- Mallet toe (flexed DIPJ)
- Curly toes
What is an achilles tendinopathy
Degenerative disorder of the achilles tendon causing swelling and pain (not inflammatory)
What are the signs and symptoms of achilles tendinopathy?
- Pain and stiffness in the morning
- Thickening of the tendon
- Swelling
- A palpable bone spur
What is a flat foot (Pes planovalgus)?
Collapsed medial longitudnial arch of the foot with valgus angulation of hindfoot
What are the two types of flat foot?
1) Flexible flat feet = medial arch appears when standing on tip-toes
2) Rigid flat feet = no medial arch at all
- usually results from tarsal coalition (failure of tarsal bones to separate during embryonic development)
- often symptomatic
What is charcot arthropathy?
Progressive destruction of the bones, joints and soft tissues commonly from diabetic foot diseases
