INJURIES TO THE PHALANGES

Question 1

Sprained Toes

Answer 1

Etiology
Kicking non-yielding object
Pushing or twisting joint beyond normal ROM disrupting ligaments & joint capsule

Sign & Symptoms
Pain is immediate & intense but short lived
Immediate swelling & discoloration occurring w/in 1-2 days
Stiffness & residual pain will last several weeks

Management
Buddy taping toes to immobilize
Begin weight bearing as tolerable

Question 2

Turf Toe

Answer 2

Sprain of 1st metatarsophalangeal (MTP) joint
Etiology
Hyperextension injury
single or repetitive trauma

Signs & Symptoms
Pain & swelling which increases during push off in walking, running, & jumping

Management
Increase rigidity of forefoot in shoe
Taping the toe to prevent extension

Question 3

Fractures & Dislocations of the Phalanges

Answer 3

Etiology
Kicking un-yielding object
Toes are stepped on
Dislocations less common than fractures

Signs & Symptoms
Immediate & intense pain
Obvious deformity

Management
Dislocations reduced by a physician
Casting w/ great toe or multiple toe fractures
Buddy taping may work

Question 4

Morton’s Toe

Answer 4

Etiology
Abnormally short 1st metatarsal, 2nd toe looks longer than 1st toe
Stress fracture could develop

Signs & Symptoms
Pain during & after activity w/ possible point tenderness
Bone scan positive
Callus development under 2nd metatarsal head

Question 5

Foot Deformities and Conditions

Answer 5

Claw toes
Flexion contracture at the DIP & Hyperextension at the MP

Hammer toes
Flexion contracture at the PIP

Mallet toes
Flexion contracture at the DIP
FDL Tendon

Etiology
Often caused by wearing short/small shoes over extended period of time

Question 6

Subungual hematoma

Answer 6

Etiology
Stepped on
kicked something unforgiving

Signs & Symptoms
Pain
build up of blood under the nail

Management
Release pressure by draining blood through a hole in the nail

Question 7

Athlete’s foot

Answer 7

caused by a fungus, usually occurring between the toes
warm, dark, and humid environment encourages fungus growth
S/S-are dry skin, itching, scaling, inflammation, and blisters
contagious

Treatment-Fungicidal and fungistatic chemicals
Prevention-
Avoid walking barefoot; use shower shoes.
Reduce perspiration by using talcum powder.
Wear light and airy shoes.
Wear socks that keep your feet dry

Question 7

Ingrown toenail (onychocryptosis)

Answer 7

occur when the edges or corners of your nails grow into the skin next to the nail

Causes: improper cutting,tight shoes, improper hygiene

Tx: warm water soak, push skin away from edges of nail, neosporin, sx may be necessary if deep

Question 8

Blisters

Answer 8

Causes
result of heat, moisture and friction.
Friction forces caused by inappropriate footwear.
fungal infections of the skin, allergic reactions or burns.
Excessive foot perspiration.

Prevention-proper fitting shoes/socks, keep feet dry, foot powder

Treatment- drain if painful, apply antibiotic, do not remove protective “roof” skin, cover with bandaid