the foot & ankle. 1/4/20162 bony anatomy of the foot
TRANSCRIPT
The Foot & Ankle
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Bony Anatomy of the Foot
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Muscles of the Lower Leg
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Muscles of the Lower Leg
Common Injuries to the Foot & Ankle
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Fractures
• MOI: combo of plantar flex & inversion
• S/S: Edema, deformity ecchymosis, point tender, ROM, & pn with wt. bearing
• Special Tests: Percussion Test or Compression Tests
• Management: Splint, Ice
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Dislocations & Subluxations
• MOI: Twisting Motion• S/S: Loss of function,
severe pn, swelling, & deformity
• Special Tests: None• Management: Check
Dorsal Pedal Pulse, Splint, Refer to MD
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Contusions
• MOI: Direct blows or improperly fitted shoes
• S/S: point tender over heel
• Special Test: Palpation of heel
• Management: Ice, Donut pad
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Sprains
• MOI: Stepping on something, in a hole, or land off balance (85% are inversion, involving the ATF ligament)
• S/S: ROM, crepitation, point tender, instability, immediate edema
• Special Test: Talar Tilt, Anterior Drawer, Kleiger’s
• Management: Bracing or taping, RICE, strengthening
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Tendon Ruptures
• MOI: Abrupt starts & stops
• S/S: severe pn, swelling, deformity, loss of function
• Special Tests: Thompson Test
• Management: Ice, Splint, Refer to MD
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Turf Toe
• MOI: jamming great toe in end of the shoe
• S/S: point tender, pn with push off, swelling
• Special Tests: None• Management: RICE,
NSAID’s, Taping, or stiff-soled shoes
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Hammer & Claw Toe
• MOI: often congenital, but can be caused by improperly fitted shoes, or muscles contractures
• S/S: Hammer-flexion deformity at DIP Claw: hyperext. MTP & hyperflex of DIP & PIP joints
• Special Tests: none• Management: padding
controls symptoms, but surgery needed to treat condition
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Ingrown Toenail
• MOI: Improper cutting or shoe size• S/S: pn, swelling over site, redness• Special Test: None• Management: Soak foot, then cotton or “V”
shape cut
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Morton’s Neuroma
• MOI: tight fitting shoes• S/S: pn in the 2nd and 3rd
metatarsal spaces that can radiate into the toes
• Special Test: Interdigital Neuroma Test
• Management: Wider toe box, NSAIDs, low heels, metatarsal pads, possibly cortisone shots
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Plantar Fasciitis• MOI: Excessive or
prolonged pronation, tightness of the Achilles, obesity
• S/S: pn on bottom of foot usually noticeable 1st thing in morning, subsides & builds again during the day
• Special Test: None• Management: Ice massage,
NSAIDs, stretching exercises, heel lift, or taping
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Bunions(aka Hallux Valgus)
• MOI: foot pronation, arthritis, ligament laxity
• S/S: medial aspect of MTP with hallux shifting laterally
• Special Test: None
• Management: little can be done, straping, surgery for severe cases
Syndesmotic Sprain
• AKA – high ankle sprain
• MOI – Ankle external rotation
• S/S: pn on the superior/anterior portion of ankle
• Special: Squeeze• Tx: Roman Sandal04/21/23 20
Shin Splints (aka MTSS)• MOI: chronic condition, running on different
surfaces, poor arches• S/S: Pain over anterior medial tibia that increases
with activity• Tests: none• Tx: RICE, Tape, ice massage, strengthen anterior
tibialis muscle
Deep Vein Thrombophlebitis (DVT)
• Aka Blood Clots
• MOI:post-Surgery or Direct Blows
• S/S Pain in the legs
• Tx- Medical Emergency Hospital
• Homan’s Sign04/21/23 22