Adult Foot and Ankle Disorders Flashcards Preview

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Flashcards in Adult Foot and Ankle Disorders Deck (52):
1

What is the test to see how tight the gastrocneumius is?

Silverskiolds- dorsiflfexion with a straight leg and then with knee bent

2

What is the common name for pes planus?

flat feet

3

How can you tell flexible flat feet from inflexible?

flexible flat feet form an arch when the patient tip-toes

4

What is the most common cause of acquired flat feet in adults?

tibialis posterior dysfunction

5

What is the course of the tibialis posterior?

courses immediately posterior to medial malleolus and attaches on to the plantar aspect of medial and middle cuneiforms and navicular

6

What are the functions of tibialis posterior?

invertor; plantar-flexor; stabilises the medial longitudinal arch- elevates arch

7

Who is tibialis posterior dyfunction typically seen in ?

obese middle aged females (increases with age)

8

What are the conditions associated with tibialis posterior dysfunction?

hypertension; diabetes; seronegative arthropathies; tendinosis

9

What are the symtpons of tibialis posterior dysfunction?

pain and/or swelling posterior to medial malleolus; change in foot shape; diminshed walk ability/blanace and dislike of uneven surfaces; more noticeable hallux valgus; lateral wall "impingement" pain

10

What are the treatment options of tibialis posterior dysfunction?

PT; insoles to support medial longitudinal arch

11

What is pes cavus?

high arched feet

12

What are the causes of pes cavus?

mainly idiopathic but neurological- CP; polio; spina bifida

13

How does plantar fasciitis present?

start-up pain after rest:usually when wake-up; fullness or swelling and tenderness plantarmedial aspect of heel; sharp stabbing pain

14

What causes plantar fasciitis?

physical overload; seronegatvie arthropathy; diabetes; abonrmal foot shape; improper footwear

15

What are the treatments for plantar fasciitis?

NSAIDs; PT; heel cups or medial arch supports

16

What is the prognosis for plantar fasciitis?

usually self-limiting over 18-24 months

17

Why can hallux valgus be caused by flat feet?

if feet are always falling inwards, hallux tries to ocmpensate

18

Who gets hallux valgus?

increases ewith age; usually bilateral; females 3x more than males

19

What can cause hallux vlagus?

familial; shoes; general joint laxity; RA

20

What are the problems associated with hallux valgus?

transfer metersalgia;lesser toe impingement; pin; deformity; shoe difficulties

21

What is transfer metatarsalgia?

2nd toe has to take over main weight bearing and this causes pain

22

What is the management for hallux valgus?

shoe modificatiosn, padding etc; operative-osteotomy

23

What is hallux rigidus?

OA of 1st MTPJ

24

What are the operative options for hallux rigidus?

joint replacement and fusion

25

What is the pathogenesis of rheumatoid foot?

synovitis; proteinases and collagenases; impaired integrity of joint capsules/ligaments; destruction of hyaline cartilage

26

What is morton's neuroma?

degenerative fibrosis of digital nerve near its bifurcation

27

What are the symptoms of mortons neuroma?

forefoot pain (metatarsalgia); burning and tingling in toes

28

Who gets mortons neuroma/

45-50 years; F>M

29

What occurs with tendo-achilles tendinosis?

repetitive microtrauma, failure of collagen repair with loss of fibre alignment/structure

30

What are the symptoms of achilles tendinosis?

pain; morning stiffness, eases with heat/ walking

31

What are implicated as causes for achilles tendinosis?

over-training, some drugs- ciprofloxacin, steroids;

32

What are the treatment options for achilles tendinosis?

activity modifications/analgesia/ NSAIDs; shockwave therapy; orthotics; PT; surgery

33

What is seen on presentation of an achilles rupture?

sudden decelration with resisted calf contraction; unable to weight bear; weak plantar flexion; palpable painful gap; positive calf squeeze- if foot fails to flex (simmonsds test)

34

Who gets an achilles rupture?

usually over 40s; pre-existing tendinosis

35

What causes claw, hammer and mallet toes?

an acquired imbalance between flexors and extensores

36

What happens with claw toes?

hyperextension; flexion; flexion

37

What happens with mallet toe?

flexion only at DIP

38

What happens with hammer toe?

hyperextension; flexion; normal

39

What is the management for claw, hammer and mallet toes?

surgery- tenonotomes tendon transger; fusion

40

What type of trauma causes an ankle sprain?

twisting forces- commonly inversion or twisting forces on a planted foot

41

What is the presentation of an ankle sprain?

pain; bruising and tenderness

42

What happens with an ankle sprain?

the elastic limit of ligaments is reached which causes a tear

43

What is the management for ankle sprains?

RICE- rest; ice; compression and elevation; PT

44

What are the classifications for ankle fractures?

Webers- A- below syndesmoses
B- around syndesmoses
C- above the syndesmoses

45

What is significant about Weber class C fractures?

unstable until proven otehrwise

46

What is a stable ankle fracture?

a distal fibula fracture with no medial malleolus fracture or deltoid ligament rupture

47

What causes an ankle fracture to be unstable?

medial malleolus fracture or deltoid ligament rupture, talar shift

48

What is a Pilon fracture?

A fracture involving the distal end of the tibia at its articulation at the ankle joint

49

What usually causes a 5th metatarsal fracture?

an inversion injury

50

What is a Lisfranc fracture?

an injury where one or more of the metatarsals are dislocated from the tarsal bones

51

What often causes a calcaneus fracture?

landing on heal when falling from a height

52

What is it important to do with a calcaneus fracture?

check for other injuries