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Foot Pathologies

Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

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Page 1: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Foot Pathologies

Page 2: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Pes Cavus Abnormally High

and Rigid Arch Plane of

metatarsals Hypomobile Common

complaints

Page 3: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Pes Planus Flat feet Hypermobile

Results in: Common

Complaints Assess Using

Feiss Line Navicular Drop Test

Page 4: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Forefoot Varus

Inversion of forefoot relative to rearfoot

Medial side of foot is raised

Compensations

Page 5: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Forefoot Varus

Inversion of forefoot relative to rearfoot

Medial side of foot is raised

Compensations Common Issues

Page 6: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Forefoot Valgus

Eversion of forefoot relative to rearfoot

Lateral border of foot raised

Compensations Common Issues

Page 7: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Assessing Forefoot to Rearfoot Alignment Prone Position Rearfoot in

subtalor neutral Plane between

heel and plan of 2nd – 4th MT heads

Page 8: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Rearfoot Varus Most common Inverted calcaneus Initial contact Compensations Common

Pathologies

Page 9: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Rearfoot Valgus Eversion of

Calcaneus Hypermobile foot Common

Pathologies

Page 10: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Plantar flexed 1st Ray PF 1st ray relative to other MT’s Compensatory to

rearfoot varus Pes Cavus

Page 11: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Tarsal Coalition Bony, fibrous or cartilagenous union

between two or more tarsal bones Etiology S/S

Page 12: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Hallux Valgus Valgus deformity

of 1st MTP joint Deviations

Page 13: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Hallux Valgus

Valgus deformity of 1st MTP joint

Deviations Bunion Congruous vs

Pathological Hallux Valgus

Page 14: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Bunionette Prominence of

lateral aspect of 5th MT head

Page 15: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Hallux Rigidus Limited DF and EXT of 1st toe Due to: Pain during push-off Recognizing this:

Shoes may have an oblique crease

Page 16: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Hammer Toes Hyperextension of

MTP joint Flexion contracture

PIP joint Most common =

2nd toe Etiology

Page 17: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Claw Toes Hyperextension of

MTP joint Flexion of PIP and

DIP joint

Page 18: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Mallet Toe Flexion of DIP joint Corn and Callus

development Etiology

Page 19: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Morton’s Toe (Foot) Abnormally short

1st MT 2nd appears longer Compenssations Related

pathologies

Page 20: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Medial Longitudinal Arch Sprain

Mechanism Repetitive stress

S/S

Page 21: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Transverse Arch Sprain Mechanism

Intermetatarsal ligaments Predispositions to this injury

S/S

Page 22: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

1st Toe Sprain (Turf Toe) Mechanism

MTP joint Hyperextension

force S/S

Page 23: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Midfoot and Forefoot Sprains Mechanism Must be aware of anatomy

Page 24: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Calcaneal Apophysitis (Sever’s Disease)

Mechanism overuse

S/S

Page 25: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Retrocalcaneal And Calcaneal Bursitis

Mechanism S/S

Page 26: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Plantar Fasciitis Mechanism S/S

Page 27: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Heel Spur Mechanism S/S

Page 28: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Jones Fracture Mechanism

metaphyseal-diaphyseal junction

Don’t confuse with avulsion fracture

S/S Management

Page 29: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Other Foot Fx’s Calcaneal Fracture Talus Fracture Phalange Fractures Stress Fractures

Page 30: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Blisters Mechanism S/S Management

Intact Open

Page 31: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Callus Mechanism Prevention S/S

Page 32: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Corns Mechansim S/S

Hard Soft

Page 33: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Ingrown Toe Nail Mechanism S/S Prevention

Page 34: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Plantar Warts Mechanism S/S

Page 35: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Tarsal Tunnel Syndrome Mechanism

Acute Chronic Biomechanical

S/S

Page 36: Foot Pathologies - OrthoSurgery · Navicular Drop Test. Forefoot Varus Inversion of forefoot relative to rearfoot Medial side of foot is raised ... Valgus deformity of 1st MTP joint

Intermetatarsal Neuroma(Morton’s Neuroma) Mechanism

2 MT Between 3rd and 4th

MT