Week 3 Flashcards
Hallux rigidus
Degenerative arthritis in the 1st MTP
Ss:
Tender
Enlarged
Loss of motion
Restricted toe extension
Difficulty wearing heels
Treatment:
Conservative (orthotics, activity modification)
Hallux valgus
Thickening of the medial capsule and bursa; often due to ill-fitting footwear
Big toe veers lateral
Treatment:
Symptomatic (orthotics or padding)
Bunion
Prolonged pressure against the medial aspect of the 1st MTP joint
Thickening of capsule and bursa
-lateral shift of the great toe
Treatment:
Wide soft shoes with broad toe box, strapping or toe, and sometimes surgery
Hammer toe
Extension of the MTP joint, flexion at PIP joint and hypertension at DIP joint
Claw toe
Hyperextension MTP and flexion at PIP and DIP joint
Mallet toe
Neutral position at MTP and PIP but flexion at DIP joint
Causes for hammer, claw, and mallet toe:
Congenital, improperly fitted shoes, neuromuscular disease, arthritis, or trauma
Note. Not treated unless associated with increased risk of forefoot condition
Pes cavus
Excessively high arch that does not flatten during weight bearing (rigid foot)
Pes planus
Flat foot; arch or instep of the foot collapsing and contracting the ground
Midfoot contusion
Compression can damage extensor tendon or fracture metatarsals
MOI: direct impact- compression
SS: pain to walk and touch
Treatment: Standard acute care
Heel contusion
Thick padding of adipose tissue between skin and calcaneus
MOI: impact to heel pad (repetitive heel strike while running)
SS: pain in heel and unable to weight bear
Treatment: heel cup, cold
Gastronemius contusion
MOI: compression
SS: pain and weakness, rigid hemorrhage and muscle spasms
Treatment: cold and gentle stretch
Tibial contusions
Shin bruises (lack of padding)
MOI: repeated blows damage periosteum
SS: bruise and pain
Treatment: standard acute care
Toe and foot sprains
IP and MP: tripping and stubbing toe or sudden twisting motion
-midfoot:
MOI: severe Dorsi/plantar flexion or pronation (high impact activities)
SS: pain and swelling on medial aspect of the foot, pain in weight bearing
-Turf toe:
Sprain of the plantar capsular ligament of the 1st MTP joint
MOI: forced hyperflexion, or extension of great toe
SS: pain, point tenderness, swelling on plantar aspect of the MP joint and pain with extension
Inversion
Causes: weak ligaments, uneven surfaces, poor footwear
MOI: plantar flexion and inversion
SS:
Grade 1- pain and swelling on anterolateral aspect of the lateral malleolus
Grade 2- tearing and popping
Grade 3- swelling everywhere
Test: anterior drawer test
Eversion
Causes: weak deltoid ligament, high impact trauma
MOI: excessive dorsiflexion and eversion, deltoid ligament
SS: often cannot recall mechanism, swelling between posterior aspect of lateral malleolus and Achilles tendon
PROM: pain free except in Dorsiflexion
High ankle sprain
Injury to the anterior tibiofibular ligament and interosseous membrane
MOI: forced dorisflexion and external rotation
Treatment: taping, bracing, walking boot
Subtalar dislocation
MOI: fall from a height, foot lands in inversion and disrupts interosseous talocalcaneal and talonavicular ligament
SS: pain, total loss of function, pale and cold to the touch, shock, potential for peroneal tendon ligament and neurovascular damage
Treatment: call EMS
