conditions of foot and ankle Flashcards
what bones are fractured in an ankle fracture?
what makes an ankle fracture unstable?
what is a talar shift?
what ligaments get damaged in a talar shift?
medial and tibial mallealous
when there is damage to a ligament
when the tallus moves in an unstable fracture - there is an asymmetric space between the tallus and malleali
medial ligaments and medial mallealous
what to consider when posed with an ankle inury?
mechanism of injury - inversion or eversion
mediacl cormorbidities
soft tissue assessment (open, closed, skin at risk?, swelling and blisteres)
how to treat a stable ankle fracture?
cast or boot for comfort
can walk on it
low rate of post traumatic OA or complications
how to treat unstable ankle fractures?
surgical stabalisation
high risk of complicatins espesh in diabetic or people with poor blood supply (smokers)
what is a sprain?
how to treat?
what is the most common ligament to sprain?
when just the ligaments are damaged
rest and time (90%) heal this way
anterior talofibula ligament
what achillies tendon rupture?
what is the vascular watershed?
who is most at riskof rupture?
what is the classical thing people say?
when the tendon snaps - achillies is the largest and striongest tendon in the body
where there is the least blood supply (6cm above calcaneum)
30-50 year old sports
i fell like ive been kicked in the back of the heel
how to test for achillies tendon rupture?
other thibgs you would see?
Thompsons/simmons test - get no plantar flexsion when squeezeing the calf
tendon wont be visible and also may be a gap where it has ruptured
what other investigations can check for achillies rupture?
MRI
ultrasound
most common treatment for ruptured achillies?
how long does it take to recover?
what is the rerupture rate?
what function do pwople get back?
most treated with a boot (conservatively - not surgical)
12 months
2-8%
90-95%
what are the 4 lesser toe deformities ?
- claw toe - neurological abnormailty
- hammer toe - hallux valgus
- mallet toe
- curly toe - congenital
what is hallux valgus?
what deviation direction is there?
what is it caused by?
treatment?
what happens in the operation?
bunions - lump
there is a valgus deviation of the big toe phalange away from the midline
genetics, laxity (woment have laxer ligaments), shoes - pointy toe
chnage shoes, chnage attitude, operate
break the bone and move it over the sesmoid bones (cange angle) - not just chop
what is hallux rigidus?
what joint does it effect?
how does it present?
what would you see on an xray?
arthritis of big toe
at MTPJ (metatarsal phalanges joint)
pain at MTPJ and lump over joint, limited movement
loss of joint space, osteophytes, sunchondral sclerosis (hardening/whiter), cysts
how to treat hallux rigidus?
conervative:
orthotics and aids, painkillers, activity modification, steriod injections
surgical:
re-align = osteotomy (takes weight of joint)
remove = excision athroplasty = floppy joint so cant move
fuse = arthrodesis - fix in place - deosnt move - best treatment
replace = arthroplasty
what condition makes you more at risk of foot issues?
why?
what is charcots arthropathy?
how to treat?
what can charcots arthropathy lead to?
what is this prone to?
diabetes
neuropathy issues = loss of sensation in foot so dont realise injuries on bottom of foot= infection = sepsis = loss of tissue
is a progressive condition of the musculoskeletal system that is characterized by joint deformities and bone loss
long term plaster cast
rocker bottom foot - arch collapses
ulceration
