Foot Problems Flashcards
Forefoot problems
Hallux valgus Hallux rigidus Lesser toe deformities Morton’s neuroma Metatarsalgia Rheumatoid forefoot
What is hallux valgus
“Bunions”
Hallux valgus aetiology
Genetic
Foot wear
Female > male
Hallux valgus symptoms
Pressure symptoms from footwear
Pain from crossing over of toes
Metatarsalgia
Hallux valgus management
Non-operative =>
-Shoe wear modification
-Orthotics to offload pressure/correct deformity
-Activity modification
-Analgesia
Operative (if non-operative failed or unacceptable to patient) =>
-Release lateral soft tissues
-Osteotomy 1st metatarsal +/- proximal phalynx
-Generally good outcome but recurrence inevitable
Hallux rigidus
Pain and stiffness at joint of big toe
No joint space
Hallux rigidus management
Non-operative => -Activity modification -Shoe wear with rigid sole -Analgesia Surgery => -Cheilectomy -Arthrodesis -Arthroplasty
Lesser toe deformities
Claw toes
Hammer toes - flexion at pip joint
Mallet toes
What is Morton’s neuroma?
Mechanically induced degenerative neuropathy
Frequently associated with wearing high healed shoes
Common digital nerve relatively tethered to one metatarsal and movement in adjacent metatarsal causing mechanical shear
Symptoms of Morton’s neuroma
Typically affects 3rd followed by 2nd webspace/toes
Neuralgic burning pain into toes
Intermittent
Altered sensation in webspace
Management of Morton’s neuroma
Injections for small lesions
Surgery - excision of lesion
Rheumatoid forefoot treatment
Footwear
Surgery
Midfoot problems
Ganglia
OA
Plantar fibromatosis
Where do dorsal foot ganglia arise?
From joint or tendon sheath
Ganglia treatment
Aspiration
Excision
