Foot and ankle Flashcards
(42 cards)
what is in the Well’s criteria for DVT?
active cancer
bedridden recently >3 days or major surgery within 12 weeks
calf swelling >3cm compared to the other leg
collateral (non varicose) superficial veins present
entire leg swollen
localised tenderness along the deep venous system
pitting edema, confined to symptomatic leg
paralysis, paresis or recent plaster immobilisation of the lower extremity
previously documented DVT
alternative diagnosis to DVT as likely or more likely
what is nerve entrapment?
sensory/motor disturbance secondary to compression at superficial points / interfaces
what are the OTTOWA ankle rules?
posterior edge or tip of lateral malleolus
posterior edge or tip of medial malleolus
navicular
base of 5th metatarsal
inability to weight bear both immediately and in ED (4 steps)
what is compartment syndrome?
increased pressure within one of the bodys anatomical compartments compromises circulation and the viability of tissues contained within.
can be caused by bleeding / inflammation or tight bandages / casts
what is medial tibial stress syndrome?
early stress injury which is associated with frequent overuse that imparts load on the anterior tibia, resulting in a stress reaction
repeated traction on the periosteum puts strain on the Sharpey’s fibres (connect periosteum to bone) causes the periosteum to become inflamed (periostitis)
what are two tests for calf muscle injury?
calf raise test
thompson test (to rule out achilles rupture)
what is a test for compartment syndrome?
pain on passive stretch
what are two tests for medial tibial stress syndrome?
hop test
fulcrom test
what are the ligaments that can be affected in a lateral ligament strain, and which is most common?
ATFL (most common), CFL, PTFL (least common)
what are the attachments of the ATFL (anterior talofibular) and what does it limit?
from the lateral malleolus to the neck of talus
limits plantarflexion
what are the attachments of the PTFL (posterior talofibular)?
from the lateral malleolus to the lateral tubercle of the posterior process of the talus
limits dorsiflexion
what are the attachments of the CFL (calcanealfibular)?
from the lateral malleolus to the peroneal tubercle on the calcaneus)
limits adduction of talus
what are two tests for a lateral ligament strain and which ligaments do they test for?
anterior draw (ATFL)
talar tilt (CFL)
what ligament is affected in a high ankle sprain?
AITFL (most common)
PITFL
Interrosseous membrane
what are the attachments of the anterior tibiofibular ligament?
border of fibular notch of tibia to anterior surface of lateral malleolus
what are the attachments of the posterior tibiofibular ligament?
border of fibular notch of tibia to posterior surface of lateral malleolus
is the prognosis longer in a lateral ankle sprain or a high ankle sprain and why?
high ankle sprain takes longer
deeper, less vascular ligaments, longer healing and weightbearing can reaggravate the injury
what is achilles tenosynivitis?
inflammation of the tendons synovial sheath
which deltoid ligaments are most commonly injured?
tibionavicluar and tibiocalcaneal are most commonly injured because they are more superficial
what is more common - lateral ankle sprain or medial ankle sprain and why?
lateral ankle sprain is more common, medial is more stable (deltoid ligaments are strong) and inversion injury is more common
what is posterior tibialis tendon dysfunction?
tib post tendinopathy resulting in pain or dysfunction at the tendon, due to failed healing response of the tendon which causes a disruption in collagen fibres and an increase in non collagenous matrix
what is tarsal tunnel syndrome?
compression of tibial nerve as it passes through tarsal tunnel
what two tests would you do for tarsal tunnel syndrome?
DF and eversion (passive)
tinnels test
what are the two types of achilles tendinopathy?
insertional or mid portion
