FOOT & ANKLE Flashcards
movement in which the top of your foot points away from your leg.
PLANTAR FLEXION
where the toes are brought closer to the shin
DORSIFLEXION
curving of the nail margin that pushes under the paronychium and results in infection (paronychia)
ingrown toenail
temporary treatment for ingrown toenail
- try to get the nail out of the paronychium - can use pieces of cotton or gauze
- avoid narrow toed shoes
permanent treatment for ingrown toenail
- remove the lateral margin of the nail by resection or phenolization (applied to nail matrix - will never grow back)
- make sure nails are trimmed straight across and not curved
deformity of the PIP joint, causing it to be permanently bend
HAMMER TOE
HAMMER TOE
- deformity of the PIP joint (flexion), causing it to be permanently bend, resembling a hammer
- abnormal flexion of PIP joint of one of the four toes
- the flexion deformity of the PIP joint may be fixed or supple
- may involve contracture of FDL (flexor digitorum longus tendon), synovial contracture, poor fitting shoes, long 2nd metatarsal
- hyperextension at the MTP joint and flexion at the PIP (and DIP) joint
CLAW TOE
CLAW TOE = have to remember to think about what?
- claw toe = common feature of a neuropathic foot or pes cavus (high arches)
- need to think about autoimmune too - RA / DM - Charcot foot, poor balance (neuropathy)
high arch
flat foot
high arch = pes cavus
flat feet = pes planus
- flexion at DIP joint
MALLET TOE
MALLET TOE = most often occurs in which location
2nd toe DIP joint
MALLET TOE
- flexion at DIP joint
- usually due to tight fitting shoes
- occurs most often in 2nd toe, which is frequently the longest, and is therefore impinged in a tight fitting shoe, causing DIP flexion
- common in diabetics with peripheral neuropathy, and corns/calluses in this population may become infected
mallet toe is usually due to
ill-fitting shoes
treatment of toe deformities (hammer / claw / mallet)
⦁ wide shoes
⦁ have shoes stretched over toe
⦁ pads to decrease friction on shoe
⦁ keep mobile deformities mobile
⦁ splints / braces (to help keep the toes straight)
⦁ surgery (condylectomy - straightens toe)
METATARSALGIA
pain into the forefoot(ball of foot).
Most common location for foot pain in adults
Associated with increased stress over the metatarsal head region.
Partial or complete collapse of the transverse arch formed by the metatarsal heads
“SPLAYED TOE SIGN”
METATARSALGIA
most common location of pain with metatarsalgia
-The second and third metatarsal heads are the most common location of the pain.
Tenderness under the MP joint
Pain with plantarflexion
-The pain is often described as feeling like they are stepping on a stone.
TREATMENT OF METATARSALGIA
PADS
NSAIDS
INJECTIONS
surgical repair
BUNION
hallux valgus
WHAT HELPS? Wide shoes Orthotics Pads Low (1” )heels
whether or not to have surgery with a bunion
Reasons to have surgery
Pain
Can’t wear shoes
Diabetic, and it may lead to an ulcer
When to avoid surgery
bunion, but tolerable or no pain
changes in shoes or inserts suffice
BUNIONETTE - TAILOR’S BUNION
bunion of the 5th MTP joint
WHAT HELPS
Wide shoes** - always pick wide shoes on exam
Orthotics
“corn” pad
Surgery, when pads and shoes no longer help.
MORTON’S NEUROMA
Collapse of the transverse arch that places traction and increased pressure on the interdigital nerve.
Overpronation and tight shoes are often associated with the condition.
nerves that run between metatarsals
if certain metatarsal heads roll inwards - nerve gets pinched
every time you step = get a zinger through the foot / feels like stepping on stone in shoe,etc.
most common Morton’s neuroma location
3rd metatarsal space
Most commonly complains of a burning pain in the third intermetatarsal space (between the third and fourth distal metatarsals) that may radiate towards the toes.
