DIGITAL DEFORMITIES Flashcards
function of lesser digits?
decelerate the foot stabilize the forefoot aid propulsion kinesthetic sensation fxn disrupted with pathology
what is hammertoe deformity?
MPJ extension
PIPJ flexion
DIPJ extension
what is claw toe deformity?
MPJ extension
PIPJ flexion
DIPJ flexion
mallet toe deformity?
DIPJ flexion
main causes of hammertoe fall into what 3 dynamic categories?
flexor stabilization
flexor substitution
extensor substitution
most common cause of hammertoes?
least common cause of hammertoes?
flexor stabilization (pronated foot types)
flexor substitution (supinated foot types)
extensor substitution (seen in swing phase of gait)
etiology of the classic hammertoe?
biomechanical fault
etiology of the pre dislocation syndrome?
inflammation
etiology of the crossover toe?
combination of biomechanical fault and inflammation
best examining modality for digital deformities?
imaging used for?
what can imaging detect?
plain film radiography
surgical planning
mallet toe hallux malleus transverse plane deformity digiti adductus gun barrel sign congenital deformities
when is surgical treatment indicated?
contraindications?
failed conservative therapy
ulcerative or pre-ulcerative lesions
Pain
vascular insufficiency, uncontrolled DM, other poor surgical candidates
what are some soft tissue procedures?
tendon lengthening
- Z plasty
- percutaneous tenotomy
- used along for mild flexible deformities
tendon transfers
- girdlestone procedure (FDL transfer)
- hibbe tenosuspension )EDL transfer)
what are the osseous procedures?
arthroplasty
- PIPJ resectional
- DIPJ resectional
- digital reduction
arthrodesis
-PIPJ arthrodesis
Glissans 4 principles?
complete removal of all cartilages and intervening tissue or material
accurate and close fitting of fusion surfaces
optimal position of fusion
maintenance of bone apposition until complete fusion
considerations for post op management?
WB vs NWB bartel x-rays K-wire removal digital splintage physical therapy periodic monitoring other
