Normal Hindfoot Alignment
The main dorsoflexor and plantarflexor of the foot.
Achilles Tendon Rupture
Missed 25% of the time.
Easy to diagnose with the Thompson test.
Can be treated with a plantarflexion split or through surgery.
Achilles Tendon Rupture - Treatment
Treated non-surgically (ideal) through a plantarflexion splint.
Or treated surgically.
Big risk of DVTs (30%)
Usually due to plantarflexion/inversion.
Commonly anterior tibiofibular ligament is damaged.
Ankle Sprain - Treatment
RICE followed by early functional rehabilitation.
Sprain Not Getting Better
May be a bad actor of a sprain...
Could be a bone injury, a tendon injury, or a ligament injury.
Treatment for Broken Ankle
Reduce it before you take X-rays
Call orthopedics if you need to
Medial deviation of the first metatarsal and lateral deviation of the hallux.
Most common risk factor is genetics.
Hallux Vangus - Treatment
Other than surgery, nothing has been shown to slow the progression or correct the bunion.
Surgical indications are pain not cosmesis.
Non-operative management can include analgesia, activity modification, and accommodative footwear.
Degenerative arthritis and stiffness due to bone spurs that affect the MTP which can range in severity from mild to completely ankylosed.
Can be caused by trauma, or idiopathy.
This is NOT the end-stage of a bunion, but the two may co-exist sometimes.
Hallux Rigidus - Treatment
Rest, NSAIDS, and activity modification are the first line treatments.
Cortisone injections may also be used.
Surgery is a really good option too (but NOT arthroplasty; 50% failure with bad salvage). For surgery, it can range from a "bumpectomy" to MTP fusion.
Not necessarily a problem; many people have flat feet with no symptoms. Usually, patients just need reassurance that having flat feet can be normal.
Except, pediatric stiff flatfeet and flatfeet that have emerged.
Pes Planovalgus - Cause
Usually (99%) due to tibialis posterior tendon dysfunction.
Degenerative is more common than traumatic.
Ples Planovalgus - Treatment
Start off non-operatively (big operation).
Early stages you can use RICE, anti-inflammatory drugs, corrective orthotics.
Later, you can use ankle supports, or surgery.