Foot Problems - Other Flashcards
What is Posterior Tibial Tendon Dysfunction?
A relatively common inflammation of the post tibial tendon
How do we diagnose Posterior Tibial Tendon Dysfunction?
Clinically with double & single heel raise, along with medial or lateral pain.
+ an MRI to assess the tendon
How do we manage Post. Tibial Tendon Dysfunction
- Orthotics
- Reconstruction of tendon
- Triple fusion of subtalar, talonavicular and calcaneocuboid joints
What causes a diabetic foot ulcer?
Diabetic Neuropathy - patient unaware of trauma
Autonomic neuropathy - lack of sweating/normal sebum production -> Dry cracked skin & sensitivity to trauma
Poor vascular supply -> poor healing
How do we prevent Diabetic Foot Ulcers?
- Diabetic Control
- Smoking
- Vascular Supply
- External Pressure from shoes/splints
- Internal pressure (Deformity)
- Infection
- Nutrition
How do we treat a diabetic foot ulcer?
Surgically:
- Improve vascular supply
- Debride ulcers
- Correct deformity to reduce load on an area
- Amputation
Prognosis for Diabetic Foot Ulcer?
15% of diabetics -> ulceration
25% of ulcer patients -> Amputation
5yr patient mortality is 50%
Define Charcot Neuroarthropathy?
Any neuropathy, mostly diabetes leads to rapid bone destruction occuring in 3 stages:
- Fragmentation
- Coalescence
- Remodelling
How do we diagnose Charcot Neuroarthropathy?
consider in any Diabetic patient with acutely swollen erythematous foot, especially with neuropathy.
Look for a >3* difference between limbs, pain
Do X-ray and MRI
How do we manage a charcot neuroarthropathy?
- Prevention
- Immobilise + no-weight bearing until acute fragmentation resolved
- Correct Deformity