Financial Disclosures AnatomyAnatomyAnatomyAnatomyAnatomyAnatomyAnatomyCommon Foot and Ankle problemsMortons NeuromaPlantar FasciitisBunions and HammertoesAnkle Sprains and FracturesMorton146s Neuroma ID: 892447
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1 Foot Problems Financial Disclosures Ana
Foot Problems Financial Disclosures Anatomy Anatom
2 y Anatomy Anatomy Anatomy Anatomy Anatom
y Anatomy Anatomy Anatomy Anatomy Anatomy Common Fo
3 ot and Ankle problemsMortons NeuromaPlan
ot and Ankle problemsMortons NeuromaPlantar Fasciit
4 isBunions and HammertoesAnkle Sprains an
isBunions and HammertoesAnkle Sprains and Fractures
5 Morton’s Neuroma Mortons Neuroma M
Morton’s Neuroma Mortons Neuroma Mortons Neur
6 oma: SymptomsPain: may radiate to toe
oma: SymptomsPain: may radiate to toes feels
7 like a pebble worse with high heeled
like a pebble worse with high heeled shoesNumbne
8 ssMost Common = 3rdwebspace Mortons Neur
ssMost Common = 3rdwebspace Mortons Neuroma: Exam S
9 played toes, fullnessPalpable plantar ma
played toes, fullnessPalpable plantar massMetatarsa
10 l shift testLoss of sensation Morton
l shift testLoss of sensation Morton’s Neuroma
11 Mortons Neuroma: other tests raysEMGs,
Mortons Neuroma: other tests raysEMGs, NCSMRI Trea
12 tment: ConservativeShoe modificationWide
tment: ConservativeShoe modificationWideSoftLow hee
13 lMetatarsal supportsCortisone injections
lMetatarsal supportsCortisone injections Treatment:
14 ConservativeShoe modificationWideSoftLo
ConservativeShoe modificationWideSoftLow heelMetat
15 arsal supportsCortisone injections Corti
arsal supportsCortisone injections Cortisone Inject
16 ion Cortisone Injection Inject from dors
ion Cortisone Injection Inject from dorsal sidecm p
17 roximal to web creaseBetween the metatar
roximal to web creaseBetween the metatarsal heads G
18 o about 1cm deep1cc steroid, 1cc lidoca
o about 1cm deep1cc steroid, 1cc lidocaine Treatme
19 nt: Surgery Plantar Fasciitis Plantar Fa
nt: Surgery Plantar Fasciitis Plantar Fasciitis His
20 toryMost common ages 40 More common in m
toryMost common ages 40 More common in men than wom
21 enRunning/Impact sportsSymptomsPlantar h
enRunning/Impact sportsSymptomsPlantar heel painOft
22 en worse in AM Physical Exam Tender to p
en worse in AM Physical Exam Tender to palpation pl
23 antar heelr/o calcaneal stress fracture
antar heelr/o calcaneal stress fracture with squeez
24 e test rays: The Bone Spur Bone Spur Tre
e test rays: The Bone Spur Bone Spur Treatment NSAI
25 Ds TreatmentCalf stretches Treatment Hee
Ds TreatmentCalf stretches Treatment Heel pads Trea
26 tmentPlantar massage TreatmentNight spli
tmentPlantar massage TreatmentNight splints Treatme
27 nt: ConservativeShort leg walking cast T
nt: ConservativeShort leg walking cast Treatment (
28 controversial)Cowboy boots Cortisone Inj
controversial)Cowboy boots Cortisone Injection Dont
29 inject the bottom of the footGo medial,
inject the bottom of the footGo medial, aim for th
30 e front edge of the calacneus, touch the
e front edge of the calacneus, touch thebone1cc ste
31 roid, 1cc lidocaine This shot hurts!
roid, 1cc lidocaine This shot hurts! Surgery
32 Achilles Tendonitis TreatmentCalf stretc
Achilles Tendonitis TreatmentCalf stretchesNight sp
33 lintsNSAIDSCastingCortisone injections a
lintsNSAIDSCastingCortisone injections are NOT reco
34 mmendedSurgical debridement (rare)Not as
mmendedSurgical debridement (rare)Not associated wi
35 th tendon rupture (unless injected) Buni
th tendon rupture (unless injected) Bunions, Hammer
36 toes and Corns Bunions Hammertoes Corns
toes and Corns Bunions Hammertoes Corns Corns Bunio
37 ns, Corns and HammertoesVery commonOften
ns, Corns and HammertoesVery commonOften asymptomat
38 icOnly need to treat if: pain s
icOnly need to treat if: pain skin breakdo
39 wn Conservative Treatment:Devices Stick
wn Conservative Treatment:Devices Stick on pads(bun
40 ions and hammertoes)Toe spacersAbduction
ions and hammertoes)Toe spacersAbduction braces Med
41 ial bunion pad Conservative TreatmentOrt
ial bunion pad Conservative TreatmentOrthopedic Sho
42 esWide, roomy toe boxSoftLow heelsUsua
esWide, roomy toe boxSoftLow heelsUsually ugly Su
43 rgeryPainSkin breakdown Ankle Injuries:S
rgeryPainSkin breakdown Ankle Injuries:Sprains and
44 Fractures Ankle Sprain Ankle SprainInver
Fractures Ankle Sprain Ankle SprainInversion Sprain
45 (most common) Ankle SprainTreatmentR.I.
(most common) Ankle SprainTreatmentR.I.C.E. (rest,
46 ice, compression, elevation)Air cast (f
ice, compression, elevation)Air cast (full time 4
47 weeks, sports 4 more weeks)Crutches (if
weeks, sports 4 more weeks)Crutches (if needed for
48 comfort)Cast (36 weeks for severe cases)
comfort)Cast (36 weeks for severe cases)Wtbearing a
49 s tolerated Ankle Sprain Frank C, Woo S.
s tolerated Ankle Sprain Frank C, Woo S.L. et al, A
50 m J Sports Med.NovDec;11(6):379Created l
m J Sports Med.NovDec;11(6):379Created ligament inj
51 uries in rodentsCompared immobilization
uries in rodentsCompared immobilization to motion M
52 otionImmobilization When sprains dont ge
otionImmobilization When sprains dont get better
53 33;Expect some degree of pain, stiffness
33;Expect some degree of pain, stiffness and swelli
54 ng for 6 12 weeksIf symptoms persist, co
ng for 6 12 weeksIf symptoms persist, consider:
55 calcaneus anterior process fracture c
calcaneus anterior process fracture chondral inj
56 ury to talus failure of the ligaments
ury to talus failure of the ligaments to heal Wh
57 en sprains dont get better… Calcane
en sprains dont get better… Calcaneus anterior
58 process fracture When sprains dont get
process fracture When sprains dont get better…
59 ; Chondral injury of the talus When spra
; Chondral injury of the talus When sprains dont ge
60 t better… Inversion stress xray sho
t better… Inversion stress xray showing failur
61 e of lateral ligaments to heal Ankle Fra
e of lateral ligaments to heal Ankle Fractures Ankl
62 e Fracture Ankle Fracture Ankle Fracture
e Fracture Ankle Fracture Ankle Fracture Ankle Frac
63 ture Sprain vs FractureShould we get an
ture Sprain vs FractureShould we get an xray? The O
64 ttawa RulesHx of trauma and malleolar an
ttawa RulesHx of trauma and malleolar ankle painand
65 anyone of:Age greater than 55Inability
anyone of:Age greater than 55Inability to bear wei
66 ghtTender over posterior6cm of medial la
ghtTender over posterior6cm of medial lateralmalleo
67 lus Stiell et al, Ann Emerg Med 1992; 21
lus Stiell et al, Ann Emerg Med 1992; 21:384 Ankle
68 InjuryOttawa Rules Positive for fracture
InjuryOttawa Rules Positive for fractureNon bearing
69 , splintNegative for fractureCastSurgery
, splintNegative for fractureCastSurgeryR.I.C.EAir
70 castCrutches (PRN)Cast (PRN)Wt bearing a
castCrutches (PRN)Cast (PRN)Wt bearing as tolerated