Foot And Ankle Problems Flashcards
Are fracture blisters common after ankle fracture and how do they affect surgery?
Fracture blisters are relatively common after ankle fractures and have to heal before surgery can be performed
What is there a risk of with open ankle-fractures?
Osteomyelitis- infection of the bone
What are the ligaments likely to be broken in an ankle fracture?
Deltoid ligament, lateral ligament complex and syndesmotic ligaments
What is an ankle sprain?
A partial or complete tear of one or more ligaments of the ankle joint
What are some factors that increase the risk of ankle sprains?
Weak muscles/tendons, weak ligaments, running on uneven surface, shoes with inadequate heel support/high heels
What is the most common mechanism of injury in ankle sprains?
Inversion injury of a plantar-flexed and weight bearing foot
When there is inversion of the ankle which ligament is at the greatest risk?
The anterior talofibular ligament
In a severe sprain of the ankle why can the patient have an allusion fracture of their fifth metatarsal?
The fibularis brevis tendon is attached to tuberosity of fifth metatarsal and is under high tension in an inversion injury
In what patients do Achilles’ tendon rupture most commonly occur?
Men aged 30-50 (weekend warriors)
What actions can give rise to Achilles’ tendon rupture?
Forceful push-off (e.g jumping), a fall on outstretched dorsiflexed foot (overstretches tendon), stepping into a hole or off a kerb
What is the common site of rupture called and why is the rupture likely to occur here?
The site is called ‘vascular watershed’, this area has decreased vascular ivy and thickness
Is it more common to have a complete or partial tear of the Achilles’ tendon?
Complete
What are the signs and symptoms of Achilles’ tendon rupture?
Sudden severe pain in back of ankle/ calf (kick to heel), loud pop sound, palpable gap in tendon, pain, swelling, later bruising, inability to stand on tip toe
What test can you perform on the patient to check Achilles rupture?
Thompson’s test, patient lays on their front with foot hanging off bed, squeeze their calf and if Achilles intact foot should platarflex
How are most Achilles’ tendon ruptures treated?
Conservatively with foot being held in position in an air cast boot
What is the most cause of a bunion?
Hallux valgus
Why is a patient with hallux valgus advices not to wear heels?
Exacerbates already present condition
How can hallux valgus be treated surgically?
A metatarsal osteotomy and realignment of the fragments
What is hallux rigidus?
Osteoarthritis of the first metatarsophalangeal joint
How is hallux rigidus?
Activity modification, analgesia, orthotics/aids and sometimes intra-articular steroid injections
What percentage of osteoarthritis cases of the ankle joint are post-traumatic arthritis cases?
70-80% with a further 12% are secondary to rheumatoid arthritis
What is the gold standard treatment for OA of the ankle joint?
Arthrodesis (fusion)
What are some toe deformities?
Claw, mallet, hammer and curly toes
A what is Achilles tendonitis?
A degenerative condition leading to a thickened and degenerated Achilles’ tendon
