Professional Documents
Culture Documents
Affectations of the
Ankle and Foot
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Flexible Flat Foot
● Children
○ Absence of medial longitudinal arch
○ Treatment:
■ None
■ Raise medial border of heels of
shoes 3 mm
■ Shoe with long counter and
Thomas Heel Kohler’s Disease
● Adult ● Osteonecrosis of the navicular bone
○ Asymptomatic flatfoot - No treatment ● Uncommon
○ Severe - stiffness and pain during weight ● Insidious onset childhood (4-6 y.o)
bearing ● Discomfort and lumping
○ Unilateral, acquired ● Spontaneous recovery
○ Middle aged or older adults ● Idiopathic
○ Rupture of posterior tibial tendon ● Contributing factor - trauma
● (+) Tenderness and slight thickening over the
Claw Foot affected navicular bone
● Abnormally high longitudinal arch (cavus foot) ● Treatment:
associated with clawing of toes ○ Longitudinal arch support
● DF of MTP jt. And PF of IP jt. ○ Activity restriction
● Contracted plantar fascia
● Etiology: Metatarsalgia
○ Associated with nervous system ● Pain in region of MT heads
disorders ● Abnormal distribution of weight on forefoot
○ Peroneal muscular atrophy ● Etiology:
○ Myelomeningocele ○ Pain beneath the MT heads
○ Poliomyelitis ○ Everted/abducted foot
○ Imbalance in motor power of intrinsic
and extrinsic muscle of the foot ○ Foot with high longitudinal arch
● Symptoms: ■ 30 y.o.
○ Fatigue with exercise and tender calluses ○ Female > Male
beneath the metatarsal heads and over ● Causes:
the proximal IP jt. ○ Muscular weakness due to excessive
● Treatment: weight bearing
○ Simple stretching of fascia and Achilles ○ Tight short high heeled shoes
tendon ● Clinical Picture:
○ Wearing proper shoes ○ Burning cramping pain in the anterior
○ Metatarsal pads/bars (relieve stress on part of the foot (under middle MT heads)
the anterior portion of the foot) ○ Pain in standing and walking
@joepamps
Out-Toeing
● Cause:
○ External tibial torsion
○ Forefoot abduction
○ Retroversion of femoral neck
● Treatment:
Toe Deformities ○ Denis Browne Splint
● Hammer Toe ○ Slight degrees of out-toeing
○ DF of MTP jt.
○ PF of PIP jt.
○ (+) Tender corns and calluses on toe
○ Over activity et tightness of long flexor
tendons/pressure of a short narrow shoe
on the end of a long toe
● Claw Toe
○ Hyperextension of MTP jt.
○ Flexion of PIP and DIP
● Mallet Toe
○ Flexion of DIP
● Treatment: Diabetic Foot
○ Simple manipulation ● Ulceration or infection leading to gangrene or
○ Wide toes shoes amputations
● Vascular and neurologic
● Doppler ultrasound evaluation
● Treatment:
○ Prophylactic care
■ Always wearing shoes
○ Patient ed.