Ankle and foot exam gsp

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This is a presentation essentially for medical students .Examination of foot and ankle is an important topic for students in final year

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Ankle and foot exam gsp

  1. 1. Ankle & Foot Examination Prof. G.S.Patnaik MS{ortho} FAOI{usa},FACSConsultant Orthopedic Surgeon
  2. 2.  Stability of the ankle is dependent upon functional placement of the talus.Ankle & Foot Anatomy
  3. 3. Lateral ankle sprain is most commonAnkle Sprain
  4. 4.  Anterior drawer will be positive with gapping secondary to traumaDrawer’s Foot Sign
  5. 5.  Posterior drawer employs just the opposite forces to challenge the posterior talofibular ligament.Posterior Drawer Test
  6. 6.  Medial stability test secondary to trauma with gapping indicates potential deltoid ligament sprainMedial Ankle Sprain
  7. 7. Ankle Examination
  8. 8. Subtalar Examination
  9. 9.  Stabilize the mortise by opposing the fibula in the fibular notch (incisura fibularis tibiae)High Ankle SprainSyndesmotic Ligament Sprain
  10. 10.  Squeeze testPotts Compression orSqueeze Test
  11. 11.  Stress radiographsHigh Ankle Sprain
  12. 12. Metatarsal Examination
  13. 13. Plantar and Achilles Examination
  14. 14. Tarsal Examination
  15. 15.  Supine with knee flexed  Abrupt forcible dorsiflexion of foot  Positive test produces pain in calf or popliteal regionHoman’s TestDeep Vein Thrombophlebitis
  16. 16.  Incorrect position for performance of Homan’s test  Clinically unreliable and insensitive for DVT  Positive test possible with DVTHoman’s
  17. 17.  Analogous to carpal tunnel syndrome in the wrist…Tarsal Tunnel Syndrome
  18. 18.  Tap tibial nerve at medial aspect of ankle  Sign is present if paresthesias are produced in footTinel’s Sign
  19. 19.  affected ankle and inflate to pressure 10 mm of Hg above systolic for 1-2 minutesApply sphygmomanomete r toTourniquet Test
  20. 20.  Related to tight achilles tendon and gastrocnemius muscles  Common in runners and dancers  May lead to plantar fasciitisStrain of Plantar Fascia
  21. 21.  Sharp or shooting pain in toes  Lack of shock absorption  Resolved with foot orthotics  ExerciseMetatarsalgia
  22. 22.  Pain and paresthesias  Poorly fitting shoes increase pain  PRICE  Change shoes  OrthoticsMorton’s Neuroma
  23. 23.  Medial plantar neuroma  Thickening of medial plantar nerve, usually between the third and fourth digitsMorton’s Neuroma
  24. 24.  Patient complains of pain on the dorsum of the foot.  Palpate both dorsal and plantar aspects of foot.Metatarsalgia
  25. 25.  Pain typically is aggravated during the midstance and propulsion phases of walking or running.Metatarsalgia
  26. 26.  PRICE  Inexpensive orthotics are very effectiveMetatarsalgia Treatment
  27. 27.  Strongest tendon in the body  Provides the power in the push off phase of the gait cycleAchilles Tendon
  28. 28.  Over-training  Lack of stretching  Poor sleeping posture  Ill fitting shoes  Worn shoes  Lack of shock absorptionAchilles Tendonitis
  29. 29.  Pop or snap  Feels like a gunshot or kick  Inability to ambulateAchilles Rupture
  30. 30. Observation of Ruptured Achilles
  31. 31.  Flex knee  Squeeze calf  Mechanical contraction of gastrocnemius and soleus will not plantar-flex the footThompson’s Test
  32. 32.  Tap affected achilles tendon  Exacerbation of pain indicates strain  Inability to plantarflex foot indicates rupture  Neurologically intactAchilles Tap Test
  33. 33.  Stretching  Rest and massage  Sleeping posture  Hydration  Properly fitting shoes  Shock absorption orthoticsTreatment and Prevention of PedalProblems
  34. 34. Suggested Readingswww.drgspatnaik.com
  35. 35. Musculoskeletal Manifestations ofDiabetes Mellitus: Orthopedic and Rheumatologicafflictions in Diabetes Mellitus A review

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