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HALLUX VALGUS (BUNION)

HALLUX VALGUS

It is a condition characterised by outward deviation of great toe due to various causes and produce a bump on the inside of foot.
Its common with people who wear high heel with narrow toe box foot wear
More common in females
70% of patients will have family history of similar complaints
Patient presents with c/o difficulty in wearing shoes, pain over the bump and deformity of the great toe. This condition can be associated with flat foot, lesser toe deformities.
Weight bearing and oblique view xrays needed to assess the amount of great toe deviation and joint status in great toe and to plan the treatment
Treatment – Non operative like shoe modification, pads, spacers
Operative – soft tissue procedure, bony cuts (Osteotomy) or combined both to correct the deformity

PLANTAR FASCIITIS

PLANTAR FASCIITIS

It is a condition in which plantar fascia (a thin layer of connective tissue) gets inflamed near its origin on calcaneum
Affects men and women equally
Patient presents with heel pain often when first getting out of bed may prefer to walk on toes initially and worse at the end of the day after prolonged standing, relieved by ambulation
Xray most often normal, may show plantar heel spur
Blood investigations to be done to rule out other causes of heel pain like gout, infection
Treatment – Non operative like pain control, night splint, stretching therapy, short wave treatment
Operative – Surgical release with plantar fasciotomy

ANKLE SPRAIN

ANKLE SPRAIN

Most common reason for missed athletic participation
Most common injury in dancers
Grade of ankle sprain
Xray to be done to rule out any bony injuries, ankle instability
MRI to be considered if pain persists for 8 weeks following sprain to rule out any other cause for pain
Treatment – Non operative RICE (Rest, Ice, Compression, Elevation), Elastic wrap to minimise swelling
Operative – In chronic ankle sprain – Modified Brostrom procedure

FLAT FOOT

FLAT FOOT

It is a condition in which the longitudinal arch in the foot, which runs lengthwise along the sole of the foot, has not developed normally and is lowered or flattened out.
This condition can affect one or both feet
You have this condition when your sole makes complete or near complete contact with the ground
You can get it after an injury or because of health problem, such as rheumatoid arthritis
Most people don’t have symptoms, although weight gain, ill fitting shoes or standing a lot may cause pain in your feet and legs
Treatment – Non operative orthotic correction and physical therapy
Operative : Surgical correction of deformity

CHARCOT FOOT

CHARCOT FOOT

It is a condition in which protective sensation of the joint is lost which results in destruction of joints and surrounding bony structures may lead to amputation if left untreated
Most commonly seen in diabetic patients
Patient usually presents with swollen foot and ankle, warmth foot, redness in foot
Patient also c/o deformed foot, bony prominences, unstable joints
If bony prominence left untreated may lead to ulcer formation
Xray needed to assess the amount of joint destruction, subluxation or dislocation of the joints in foot
Blood test to rule out infection, to detect underlying pathology like diabetes mellitus
Treatment – Non operative – total contact casting, shoe wear modifications, medications
Operative – to achieve plantigrade (normal) foot that allows ambulation without skin ulcers
Resection of bony prominences, Deformity correction, arthrodesis, amputation.

ACHILLES TENDONITIS

ACHILLES TENDONITIS

Patient presents with pain backside of the heel may be due to various causes like swelling of Achilles tendon near its attachment to heel bone (calcaneum), inflammation of bursa between Achilles tendon and heel bone (Retrocalcaneal bursitis) or due to bony enlargement on backside of the heel bone (Haglund deformity)
Patient usually c/o pain on shoe wear, bony bump on the backside of the heel, swelling on either side of the Achilles tendon
Xray needed to assess any bony spur from calcaneum and any calcium deposit in tendon
MRI helps to detect the amount of damage to Achilles tendon
Treatment – Non operative – Activity modification, shoe wear modification like small heel lift
Operative – removal of diseased portion of tendon, bony bump removal from heel bone, bursa excision

CONGENITAL TALIPES EQUINO VARUS (CLUB FOOT)

CONGENITAL TALIPES EQUINO VARUS

In this condition usually baby will be brought by the parents with c/o deformity of one or both foot pointing downwards and turn inwards.
Nothing to worry about the condition it is completely correctable
Treatment – Non operative serial manipulative cast application
In severe cases surgical procedures like soft tissue release. In resistant cases, ring fixator may be required to achieve full correction

ANKLE ARTHRITIS

CONGENITAL TALIPES EQUINO VARUS

It is a condition in which joint surface of shin bone (tibia) at lower end and talus get degenerated and results in irregular joint surface which alter the load bearing mechanics of the ankle joint
Damage to joint surface of the ankle joint may happen due to trauma, rheumatoid arthritis, osteoarthritis, haemophilia
Patient usually presents with pain with weight bearing, loss of movement in ankle joint, swelling and deformity in ankle joint
Xray needed to assess the amount of joint space reduction, angular deformity of the ankle joint
Treatment option – Non operative – activity modification, pain killer, bracing
In case of failure of conservative management, operative management required in the form of either fusion of the damaged joints (Ankle arthrodesis) or replacement of the damaged joint surface (Ankle replacement)