Foot Problems Flashcards by C M

Non-operative management of foot problmes?

Analgesia, 
Shoe wear modification,
Activity modification, 
Weight loss, 
Physiotherapy,

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Forefoot problems?

Hallux valgus, 
Hallux rigidus, 
Lesser toe deformities,
Morton’s neuroma, 
Metatarsalgia, 
Rheumatoid forefoot

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What is hallux valgus?

Bunions

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Aetiology of hallux valgus?

Genetic,
Foot wear,
Female

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Symptoms of hallux valgus

Pressure symptoms from shoe wear,
Pain from crossing over of toes,
Metatarsalgia

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Pathology of hallux valgus

There is lateral angulation of the great toe caused by tendons pull realigning to the lateral of centre of rotation.

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In hallux valgus less weight goes through the toe because of….

Sesame is bone subluxation

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Non-operative management of hallux valgus?

Shoe wear modification,
Orthotics,
Activity modification,
Analgesia

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Operative treatment of hallux valgus?

Release lateral soft tissues,

Osteotomy 1st metatarsal

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What is hallux rigidus?

Stiff big toe cause by osteoarthritis of 1st MTP joint

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Hallux rigidus symptoms?

Asymptomatic,
Pain at extreme of dorsi flexion,
Limited ROM

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Non-operative management of hallux rigidus?

Activity modification, shoe wear with rigid sole, analgesia

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Operative management of hallux rigidus

Cheilectomy,
Arthodesis,
Arthroplasty

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What is a cheilectomy?

Removal of dorsal impingement

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What is arthrodesis?

surgical immobilization of a joint by fusion of the bones

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What are claw toes/

Hyperextension in MTP,

Flexion in PIP

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What is hammer toe?

Hyperextension in MTP

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What is mallet toe?

Flexion in PIP

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Lesser toe deformities aetiology?

Imbalance between flexors/extensors,
Shoe wear, 
Neurological,
Rheumatoid arthritis,
Idiopathic

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Lesser toe deformities symptoms?

Deformity,
Pain from dorsum,
Pain from plantar side

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Lesser toe deformities non-operative treatment?

Activity modification,
Change shoe wear,
Orthotic insoles

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Lesser toe deformities operative treatment?

Flexor to extensor transfer,
Fusion of interphalangeal joint,
Release metatarsophalangeal joint,
Shortening osteotomy of metatarsal

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What is Morton’s neuroma?

Mechanically induced degenerative neuropathy

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Risk factors of Morton’s neuroma?

Female,
40-60,
High heels

Symptoms of Morton’s neuroma?

Normally 3rd/2nd webspaces affected, Neuralgic burning pain into toes, Intermittent, Altered sensation in webspace

Investigations of Mortons neuroma?

Clinical, Mulders click, US/MRI

Management of Morton’s neuroma?

Steroid injection, | Excision of lesion including section of normal nerve

Causes of metatarsalgia?

Synovitis, bursitis, arthritis, neuralgia, neuromata, Freiberg’s disease

Treatment of rheumatoid forefoot?

``` Shoe wear, Orthotics, Activity, Arthrodesis (1st MTPJ), Arthroplasty (2-5th toe excision) ```

Risk factors for dorsal foot ganglia?

Arthritis, | Tendon pathology

Symptoms of dorsal foot ganglia?

Pain from pressure from shoe wear, | Pain from underlying problem

Treatment of dorsal foot ganglia

Aspiration, | Excision

Midfoot arthritis causes

Post-traumatic or | Idiopathic

Treatment of midfoot arthritis?

``` Activity, Shoewear, Orthotics, Steroid injections, Arthrodesis ```

Plantar fibromatosis define

Also called Ledderhose disease, | Dupuytrens of the foot

Treatment of plantar fibromatosis?

Shoewear, Orthotics, Excision, Radiotherapy

What is Achilles tendinosis?

Degenerative/ overuse condition with little inflammation

Name the clinical conditions of the Achilles tendinopathies?

Insertional tendinopathy (within 2cm of insertion), Non-insertional (2-7cm of insertion), Bursitis, Paratendinopathy

What is the difference between tendinopathy and paratendenopathy?

Paratendenopathy is true inflammatorym showing paratendonitis histologically, Is common in the athletic population Whereas tendinopathy is common in non-athletic propulsion

Risk factors of tendonopathy?

>40, Obesity, Steroids, Diabetes

Symptoms of Achilles tendinopathy

``` Pain during exercise, Pain following exercise, Recurrent episodes, Difficulty fitting shoes, Rupture ```

Diagnosis of Achilles tendinopathy?

Clinical (tenderness, Simmonds and angle of the dangle tests) US, MRI

What are the Achilles Rupture tests?

Simmonds, | Matles

Non-operative treatment of Achilles Tendinopathy?

``` Activity modification, Weight loss, Shoe wear modification, Physiotherapy, Extra-corporeal shockwave treatment, Immobilisation ```

Operative treatment of Achilles tendinopathy?

Gastrocnemius recession, | Release and debridement of tendon

What is fasciosis?

``` Chronic degenerative change, Fibroblast hypertrophy, Absence inflammatory cells, Disorganised and dysfunctional blood vessels and collagen, Asvascularity ```

What is plantar fasciitis?

Fasciosis and the body cant make extra cellular matrix required for repair and remodelling

Risk factors of plantar fasciitis?

Athletes high intensity or rapid increase in training, Running with poorly padded shoes or hard surfaces, Obesity, Occupations involving prolonged standing, Foot/ lower limb rotational deformities, Tight gastro-soleus complex

Plantar fasciitis symptoms?

Pain first thing in the morning, Pain on weight bearing after rest, Pain located at origin of plantar fascia

DD of plantar fasciitis

Nerve entrapment syndrome, Arthritis, Calcaneal pathology

Treatment for plantar fasciiitis?

``` Rest, Change training, Stretching, Ice, NSAIDs, Orthoses, Physiotherapy, Weight loss, Corticosteroids injection, Night splinting ```

New treatment for plantar fasciitis?

``` Extracorporeal shockwave therapy, Topaz plasma coblation, Nitric Oxide, Platlet rick plasma, Endoscopic/open surgery ```

Non-operative management of ankle arthritis?

Weight loss, activity modification, analgesia, physiotherapy, steroid injections

Operative management of ankle arthritis?

Arthrodesis, | Joint replacement

What is tibialis posterior tendon dysfunction

Acquired adult flat foot planovalgus

Clinical diagnosis of tibialis posterior tendon dysfunction

Double and single heel raise

Symptoms of tibialis posterior tendon dysfunction

Medial or lateral pain

Treatment of tibialis posterior tendon dysfunction

Orthoses (medial arch support), Reconstruction of tendon, Triple fusion

What are the 3 stages of Charcot neuroarthropathy bone destruction

Fragmentation, Coalescence, Remodelling