1. Conservative= wider + deeper shoes 2. Surgical= osteotomies

ortho- foot and knee Flashcards by Amy Hollis

bunion presentation

deformity of great toe
medial deviation of 1st metatarsal
lateral deviation of toe itself

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bunion management

Conservative= wider + deeper shoes

2. Surgical= osteotomies

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where is a stress fracture most commonly found?

2nd metatarsal

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presentation of Morton’s neuroma?

burning pain in affected toe

- most commonly in 3rd/4th metatarsals

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what is a mortons neuroma?

-irritated and swollen nerves from a neuroma

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what causes stress fractures?

repetitive activity

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treatment for Mortons neuroma?

conservative:

pad or insole
steroids/ LA injections

Surgical:
-excision of neuroma

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what is Charcot joint?

diabetic neuropathic joint

- damaged 2ndry to sensory loss

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what is Talipes Equinovarus?

club foot

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treatment of Talipes Equinovarus?

manipulation + progressive casting (soon after birth) for 6 to 10 weeks
85% need achilles tenotomy

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what increases risk of Achilles tendon rupture?

Ciprofloxacin use

- repetitive strain

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what test is +ve for Achilles tendon rupture?

Simmons test

-squeeze calf muscle to move foot

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treatment for achille’s tendon rupture?

series of casts with foot plantarflexed

- surgical tendon repair

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most common cause of heel pain?

-plantar fascitis

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cause of plantar fascitis?

-repetitive stress/ overload

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presentation of plantar fascitis?

-pain felt on instep of foot

management of plantar fascitis?

rest feet

- insoles and heel pads

when should ankle fracture get an Xray?

Ottawa Ankle Rules

Refer for Xray if they have pain in malleolar zone (lateral or medial) and one of:

cannot wait bear for 4 steps
distal tibia tenderness
distal fibula tenderness

most common ankle inversion injury?

Anterior inferior tibiofibular ligament (AITFL)- 90%

what causes low/high ankle injuries?

low= inversion
high= eversion

(high-eeee E=eversion)

name 1, 2, 4, 6

1= PCL
2= ACL
4= lateral meniscus
6= medial meniscus

what is 8, 10, 11, 12 and 14?

8= lateral collateral ligament
10= medial collateral ligament
11= patellar tendon (cut)
12= head of fibula
14= iliotibial band insertion

twisting injury
POP noise

most likely?

ACL injury

investigations ACL injury?

+ve Anterior drawer test (90 degrees)
+ve Lachman test (30 degrees)

Lachman= go to man= more reliable

management for ACL injury?

-ask patient to return in 6 to 7 days to re examine (to allow swelling to go down)

most common cause of PCL injuries?

dashboard injuries (patient has feet on dashboard)

test for PCL injury?

posterior drawer test

- Skiing injury - Valgus stress (lateral force) most likely?

MCL injury | M= mountain= skiiing

what type of knee injury is commonly least commonly found as an isolated injury?

LCL

cause of patella fracture?

-direct blow or sudden twist of knee

which way doe the patella commonly dislocate?

-laterally

cause of quadriceps tendon rupture?

- landing injury on partially bent knee | - Ciprofloxacin use (fluroquinolones)

how does quadriceps tendon rupture present?

-cannot extend knee

what is seen on Xray of quadriceps tendon rupture?

-inferiorly displaced patella

treatment of quadriceps tendon rupture?

- knee immobilization brace | - surgical repair

who is IT band syndrome common in?

runners

where does IT band syndrome pain present?

in the knee

treatment for IT band syndrome?

- iliotibial band stretches | - physiotherapy

presentation of meniscus tears?

- usually caused by twisting injuries - locking, giving way - tenderness across joint line +ve Thessaly's test= knee pain weight baring at 20 degrees holding onto doctor +ve McMurray's test= painful click upon bending and rotating knee Medial meniscus tear= pain + swelling (highly vascular) Lateral meniscus teat= no pain or swelling (Lateral is more laid back, medial makes you moan)