FOOT/TOES  COMMON INJUIRES   KIN 191A Advanced Assessment of  Lower Extremity Injuries
INTRODUCTION <ul><li>COMMON INJUIRES </li></ul><ul><ul><li>FOOT/TOE PATHOLOGIES </li></ul></ul><ul><ul><li>GREAT TOE INJUR...
FOOT/TOE PATHOLOGIES <ul><li>Many foot/toe injuries/conditions relative to either biomechanics at the foot or as compensat...
GREAT TOE INJURIES <ul><li>M T P joint sprain (aka “turf toe”) </li></ul><ul><ul><li>Typically associated with hyperextens...
METATARSAL/PHALANGEAL INJURIES <ul><li>Metatarsal fractures </li></ul><ul><ul><li>Typically traumatic onset  </li></ul></u...
<ul><li>Avulsion fractures </li></ul><ul><ul><li>Most common at base of 5 th  metatarsal </li></ul></ul><ul><ul><li>Also o...
TARSAL INJUIRES <ul><li>Lisfranc sprain, fracture/dislocation </li></ul><ul><ul><li>Characteristic location, extended trea...
<ul><li>Calcaneal fracture </li></ul><ul><ul><li>Typically high velocity injuries (fall from height, MVA, etc.) </li></ul>...
PLANTAR SURFACE INJURIES <ul><li>Plantar fasciitis </li></ul><ul><ul><li>Biomechanical and structural issues predispose ti...
<ul><li>Fat pad contusion </li></ul><ul><ul><li>Associated with direct trauma (falls from height, etc.) </li></ul></ul><ul...
SOFT TISSUE INJURIES <ul><li>Muscle strains </li></ul><ul><ul><li>Eccentric overload vs. forceful concentric contraction <...
ARCH INJURIES/CONDITIONS <ul><li>Pes planus (“flat feet”) </li></ul><ul><ul><li>Congenital, biomechanical or traumatic ons...
<ul><li>Transverse metatarsal arch conditions </li></ul><ul><ul><li>Pain under heads of 2 nd -5 th  metatarsals due to abn...
NEUROLOGICAL INJURIES <ul><li>Tarsal tunnel syndrome </li></ul><ul><ul><li>Tibial nerve entrapment/compression posterior t...
Tarsal Tunnel Syndrome Surgery
Upcoming SlideShare
Loading in...5
×

Kin191 A. Ch.4. Foot. Toes. Inuries. Fall 2007[1]

543

Published on

Published in: Health & Medicine
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
543
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
31
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

Kin191 A. Ch.4. Foot. Toes. Inuries. Fall 2007[1]

  1. 1. FOOT/TOES COMMON INJUIRES KIN 191A Advanced Assessment of Lower Extremity Injuries
  2. 2. INTRODUCTION <ul><li>COMMON INJUIRES </li></ul><ul><ul><li>FOOT/TOE PATHOLOGIES </li></ul></ul><ul><ul><li>GREAT TOE INJURIES </li></ul></ul><ul><ul><li>METATARSAL/PHALANGEAL INURIES </li></ul></ul><ul><ul><li>TARSAL INURIES </li></ul></ul><ul><ul><li>PLANTAR SURFACE INJURIES </li></ul></ul><ul><ul><li>SOFT TISSUE INJURIES </li></ul></ul><ul><ul><li>ARCH INJURIES/CONDITIONS </li></ul></ul><ul><ul><li>NEUROGICAL INJURIES </li></ul></ul>
  3. 3. FOOT/TOE PATHOLOGIES <ul><li>Many foot/toe injuries/conditions relative to either biomechanics at the foot or as compensation for abnormal biomechanics elsewhere in the lower extremity </li></ul>
  4. 4. GREAT TOE INJURIES <ul><li>M T P joint sprain (aka “turf toe”) </li></ul><ul><ul><li>Typically associated with hyperextension </li></ul></ul><ul><ul><li>Especially problematic during push-off and change of direction activities </li></ul></ul><ul><li>Hallux valgus (aka “bunion”) </li></ul><ul><ul><li>A typical for traumatic onset </li></ul></ul><ul><li>Hallux rigidus </li></ul><ul><ul><li>Ankylosis (joint fusion) </li></ul></ul><ul><ul><li>Secondary to arthritis or exostosis formation </li></ul></ul>
  5. 5. METATARSAL/PHALANGEAL INJURIES <ul><li>Metatarsal fractures </li></ul><ul><ul><li>Typically traumatic onset </li></ul></ul><ul><ul><li>Jone’s fracture </li></ul></ul><ul><ul><ul><li>A fracture of the 5 th MT, 1cm distal to the proximal diaphysis </li></ul></ul></ul><ul><ul><ul><li>Often require surgical fixation </li></ul></ul></ul><ul><li>Metatarsal stress fractures </li></ul><ul><ul><li>Known as “march” fractures from high incidence in military recruits </li></ul></ul>
  6. 6. <ul><li>Avulsion fractures </li></ul><ul><ul><li>Most common at base of 5 th metatarsal </li></ul></ul><ul><ul><li>Also occur at navicular and calcaneal tuberosity </li></ul></ul><ul><li>Phalangeal fractures </li></ul><ul><ul><li>Typically from blunt trauma, usually treated conservatively </li></ul></ul>
  7. 7. TARSAL INJUIRES <ul><li>Lisfranc sprain, fracture/dislocation </li></ul><ul><ul><li>Characteristic location, extended treatment and rehab period, frustrating injury </li></ul></ul><ul><li>Cuboid syndrome </li></ul><ul><ul><li>Pain at cuboid/4 th and 5 th metatarsal region from subluxation of cuboid during over pronation </li></ul></ul><ul><li>Navicular fracture </li></ul><ul><ul><li>Stress fracture most common due to placement in medial longitudinal arch </li></ul></ul><ul><ul><li>Can see accessory navicular which is congenital presentation of medial prominence on navicular </li></ul></ul>
  8. 8. <ul><li>Calcaneal fracture </li></ul><ul><ul><li>Typically high velocity injuries (fall from height, MVA, etc.) </li></ul></ul><ul><li>Calcaneal apophysitis (Sever’s disease) </li></ul><ul><ul><li>Traction injury to growth plate at calcaneal tuberosity </li></ul></ul><ul><li>Talus fracture/OCD </li></ul><ul><ul><li>Most common location is dome, typically not isolated condition but secondary to other injury </li></ul></ul><ul><li>Retrocalcaneal bursitis (“pump bumps”) </li></ul>
  9. 9. PLANTAR SURFACE INJURIES <ul><li>Plantar fasciitis </li></ul><ul><ul><li>Biomechanical and structural issues predispose tissue to injury </li></ul></ul><ul><ul><li>Presents typically at calcaneal attachment but may be along length of structure </li></ul></ul><ul><ul><li>Plantar fascia rupture can occur with forces toe hyperextension to a dorsiflexed ankle </li></ul></ul><ul><ul><li>Pain when stepping out of bed in the morning </li></ul></ul>
  10. 10. <ul><li>Fat pad contusion </li></ul><ul><ul><li>Associated with direct trauma (falls from height, etc.) </li></ul></ul><ul><li>Heel spur </li></ul><ul><ul><li>Bony exostosis (Wolff’s law) </li></ul></ul><ul><ul><li>May or may not be associated with plantar fasciitis </li></ul></ul>
  11. 11. SOFT TISSUE INJURIES <ul><li>Muscle strains </li></ul><ul><ul><li>Eccentric overload vs. forceful concentric contraction </li></ul></ul><ul><li>Tendinitis </li></ul><ul><ul><li>Posterior/anterior tibialis, peroneal, Achilles, flexor/extensor tendons </li></ul></ul><ul><ul><li>Repetitive stress injuries (microtrauma) associated with biomechanics and changes in training pattern </li></ul></ul><ul><li>Synovitis </li></ul><ul><ul><li>Can occur in any synovial joint, in foot most common at the great toe MTP joint </li></ul></ul>
  12. 12. ARCH INJURIES/CONDITIONS <ul><li>Pes planus (“flat feet”) </li></ul><ul><ul><li>Congenital, biomechanical or traumatic onset </li></ul></ul><ul><ul><li>Rigid (structure) pes planus </li></ul></ul><ul><ul><ul><li>Tarsal coalition: absence of medial longitudinal arch when the foot is both WB or NWB </li></ul></ul></ul><ul><ul><li>Flexible (supple) pes planus </li></ul></ul><ul><ul><ul><li>The arch appears normal during NWB but disappears when the foot is WB </li></ul></ul></ul><ul><li>Pes cavus </li></ul><ul><ul><li>Poor ability to attenuate ground reaction forces </li></ul></ul><ul><ul><li>High incidence of stress fractures </li></ul></ul>
  13. 13. <ul><li>Transverse metatarsal arch conditions </li></ul><ul><ul><li>Pain under heads of 2 nd -5 th metatarsals due to abnormal weight bearing </li></ul></ul>
  14. 14. NEUROLOGICAL INJURIES <ul><li>Tarsal tunnel syndrome </li></ul><ul><ul><li>Tibial nerve entrapment/compression posterior to medial malleolus </li></ul></ul><ul><ul><li>Neuro symptoms along distal distribution </li></ul></ul><ul><li>Intermetatarsal neuroma </li></ul><ul><ul><li>Interdigital nerve entrapment </li></ul></ul><ul><ul><li>Morton’s neuroma (between 3 rd and 4 th metatarsal heads) </li></ul></ul><ul><ul><li>Pain at site and neuro symptoms distal to injury site </li></ul></ul>
  15. 15. Tarsal Tunnel Syndrome Surgery
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×