Foot/Ankle Flashcards
What % of the pop has foot probs
80%
What mvmt does the tibiofibular jt allow for
small spread of 1-2mm to allow dorsiflexion
how much weight of the body does the fibula hold
17% (more when dorsiflexed)
What mvmt does the talocrural jt allow for
very mobile in PF
stable in DF
What ligs support the medial talocrural jt and what do they resistq
deltoid ligament- resist talar abduction, lat translation + lat rotation
What ligs support the lateral talocrural jt and what do they resist
ATFL- mc strained in plantar flex
CFL- neutral foot for strain
PTFL- resists df, adduction and medial translation of talus
When is the subtler jt in closed packed pos
sup
what are the 4 sets on jts in the midfoot
- Tarsometatarsal
- Intermetatarsal
- Metatarsophalangeak
- Interphalangeal
How does supination occur in the foot
inversion rot of calcareous/hindfoot, forfoot adduction and inward rot of tarsometatarsal jt
How does pronation occur in the foot
Evenersion rot of calcareous, forfoot abduction, outward rot of tarsometatarsal jt
What is the normal fick angle
12-18
What is the haggling deformity
calcification on calcareous
What is bunionettes bunion
prominence of lat aspect of the 5th toe metatarsal head
What is claw toes and why does it occur
hypertext of the MTP jt and flex of PIP and DIPS
-caused by defective lumbricles and interosseous mm
What is crossover toe and why does it occur
medial deviation in 2nd/3rd toes
-weakening of lat collateral lig MTP jt and insufiencency of plantar plate
what is curly toe and what is it due to
Flexion of both PIP and DIPs with MTP jt neutral
due to contracture of FDB and FDL tendons
What is equines deformity and what is it due to
limited DF of talocrural jt
from contracture of gastric, soles, Achilles
(leads to excessive pronation at subtler jt)
What it the pathogenesis of exostosis and mc loc
increased bone mass @ site of irrative lesion due to overuse
mc- dorsal TMT jt and head of 5th , calcaneous
What is hallux rigidus and what is it due to
DF of great toe limited by OA of MTP jt
What is hammer toe and what is it due to
extension contracture @ MTP jt and flexion contracture at PIP
-interosseus mm lose there flexion effect on prox phalanx
What is mallet toe
flexion deformity of DIP on any of the lateral 4 toes
What is metatarsus adductus- who is it common in, how to resolve
mc foot dev in kids
-foot appears adducted and sup
-85-90% resolve spontaneously
what is mortons foot
2nd toe longer than the first
What is mortons metatarsalgia and what is it due to
Formation of interdigital neuroma due to injury to an interdigital nerve (typically bw 3-4th toes)
*pain bw bones)
What is plantar flexed first ray- congenital and aquired cause
big toe lies lower than other 4
congenital- caves foot
acquired- compensation for tibia varum
What is rocker bottom foot and how is it dx
foorfoot is dorsiflexed in the hind foot
-med/lat arches absent
what is turf toe and what is it due to
Hyperextension injury combined with compressive loading to the MTP jt of hallux
Grade I, II, III lat ankle sprain- what is affected + recovery times
I- mild stretch usually ATFL, recovery 8 days
II- complete tear ATFL or partial ATFL+CFL, 20 days
III- Complete tear ATFL, ant capsul, CFL, 40 days
Anterolat ankle impingement clinical prediction rules
5/6
- antlat ankle jt tenderness
- antlat ankle jt swelling
- pain on forced dorsiflex
- pain on affected side w single leg squat
- pain w activities
- abscence of ankle instability
Syndesmosis injuries- mc spot and tests
mc medially
- look for pain at the syndesmosis that may extend prox
- inability to bear weight
- may or may not have swelling
- MRI best for imaging
- EXT rot test/ squeeze test/ heal thump test
What will indvs with achilles tendon tear have at rest
more dorsiflexed w in prone pos
What is associated with achilles tendon tears
high % of ruptures show signs of tendinopathy
typical presentation of plantar fascitis
- heal pain in AM or after not moving
- pain to palpation of plantar calcanea region
- pain w dorsiflexion
mc sites of deep peroneal nerve entrapment and what does it cause
sup/inf extensor retinaculum
-loss of dorsiflexion
when is the superficial peroneal nerve affected
typically from inversion sprain
What does the tibial n supply and if compressed @ tarsal tunnel/ knee what occurs
supplies entire post leg and plantar foot
tarsal tunnel- pain over medial ankle
knee- lose PF, inversion, toe flex, ad/ab
Which nerve causes pain along the longitudinal arch
medial plantar nerve
What does lateral plantar nerve injury cause
chronic, dull, aching heal pain accentuated by walking/running but no numbness
