Musckoloskeletal: Ankle and Foot Flashcards
Ankle Sprain #1 musculoskeletal injury
-Inversion most common mechanism of injury, 90% are lateral
- + Anterior drawer exam
- +/- talar tilt test
- Tx: Rest, ice, compression, elevation. Immobilize-CAM boot for more severe sprains
- Operative: severe injury, athletes
Achilles Tendon Rupture
- Exam: Defect, + Thompson test
- US or Xray for imaging
- Tx: cast in plantar flexion, NWB, frequent cast changes, slowly bringing up foot
- Operative-tendon repair
Thompson Test
Prone, feet hang, squeeze calf: Absent plantar flexion = Achilles tendon rupture
Homan’s Sign
Knee extended, passively dorsiflex foot: Pain in calf = DVT
Compression Test
Squeeze foot at MT heads: Morton’s neuroma
Tinel’s Sign
Tap nerve posterior to medial malleolus: Posterior tibial nerve entrapment
Metatarsal/Phalangeal Fracture
-Pain with weightbearing
-Tx: Non displaced-Hard soled shoe (Darco), WBAT, elevation, ice, buddy tape-toes
-Operative: Jones-ORIF
Charcot/Neuropathic Joint
-Neurological disease results in decreased sensation
-Joint is destroyed by fracture
-Undetected by patients
-Exam: Patient is insensate, red, warm, swollen joint
-Xray-joint destroyed
-Tx: immobilize in total contact cast, frequent skin checks
-Operative-fusion
Charcot/Neuropathic Joint
-Neurological disease results in decreased sensation
-Joint is destroyed by fracture
-Undetected by patients
-Exam: Patient is insensate, red, warm, swollen joint
-Xray-joint destroyed
-Tx: immobilize in total contact cast, frequent skin checks
-Operative-fusion
Gout
-Purine metabolism defect
-Urate crystals create synovitis
-Great toe is the most common site
-More common in men
-Pain is acute and severe
Gout exam and Tx
-Red, swollen great toe, can be confused with infected joint
-Labs: Uric acid elevated
-Tx: NSAIDs, Colchicine, rest, allopurinol-prevention
