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