Term
bow legged
tight calf mm
prev injury |
|
Definition
|
|
Term
| What is the most commonly injured ankle ligament? |
|
Definition
|
|
Term
| MOI of ankle most ankle sprains |
|
Definition
| inversion and plantar flexion |
|
|
Term
| Sequence of injury of most ankle sprains |
|
Definition
|
|
Term
|
Definition
Stress xrays (space bw tibia and talus)
anterior drawer test
MRI (chronic) |
|
|
Term
| how would you test the ATFL for stability |
|
Definition
| anterior drawer test of the ankle |
|
|
Term
| never attempt a stress xray on |
|
Definition
| an injured ankle of a skeletally immature indiviusal |
|
|
Term
| if a kid has an ankle sprain assume |
|
Definition
|
|
Term
| dx of kid with ankle sprain? |
|
Definition
MRI
splint kid for 3 weeks and then they are usu fine |
|
|
Term
ATFL only injured
Minimal change on inversion stress
normal anterior drawer test |
|
Definition
| Grade I lateral ankle sprain |
|
|
Term
Complete tear of ATFL
stretching of the CFL
laxity with inversion stress
Positive anterior drawer test |
|
Definition
| Grade II lateral ankle sprain |
|
|
Term
Complete tear of the ATFL + CFL +/- PTFL
Uncommon
can be associated with fx |
|
Definition
| Grade III lateral ankle sprain |
|
|
Term
| physical therapy for ankle sprains |
|
Definition
|
|
Term
inadequate rehab and healing
invertor/evertor m imbalance
abnormal knee alignment (varus) |
|
Definition
| recurrent sprains etiology |
|
|
Term
rarely an isolated injury
usu seen w fx
can lead to posterior tendon rupture |
|
Definition
|
|
Term
-season ending injury
-proximal pain
-worse pain with external rotation
-dx on xray with foot everted |
|
Definition
| "High" Sprain - syndesmosis sprain/disruption |
|
|
Term
| what classification ranks ankle fxs |
|
Definition
|
|
Term
-fibula fx below talotibial joint
-inversion
-may have medial injury |
|
Definition
|
|
Term
-fibula fx at talotibial joint
-eversion
-may have ruptrure of tib/fib syndesmosis
-may have medial injury |
|
Definition
|
|
Term
-fibula fx above talotibial joint
-eversion
-Tib/fib syndesmotic injuty is more extensive
-may have medial injury |
|
Definition
|
|
Term
-eversion injury
-medial malleolus fx + tibfib syndesmosis injury + high fibula fx of prox 1/3
-missed with initial ankle exam |
|
Definition
|
|
Term
| what else do you look for on isolated medial maleoli fx on xray |
|
Definition
| inc space bw tib fib indicating tibfib syndesmosis injury |
|
|
Term
-usu requires surgery
-key to reduction of this fx is lateral malleorlar length and rotation |
|
Definition
|
|
Term
|
Definition
|
|
Term
| posterior malleolar is located on what bone |
|
Definition
| posterior of the distal tibia |
|
|
Term
MUST HAVE:
1) tear of the deltoid lig
2) rupture of the syndesmotic lig
3) high fx of fibula |
|
Definition
|
|
Term
-sig inc in activity or change in type of activity
-pain with push off
-swelling
-tenderness to palp |
|
Definition
|
|
Term
-weeks/months to resolve
-heel lift +/- boot cast
-do not inject!!!!!! |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| why dont we inject the achillies tendon? |
|
Definition
| it affect the collagen and my cause it to rupture |
|
|
Term
-happens to weekend warriors
-may be chronic
-inc risk with inc pronation, pes cavus, tight calf mm |
|
Definition
|
|
Term
| feels like i got hit in the back of the leg w a stick |
|
Definition
|
|
Term
| squeeze calf and foot will normally plantar flex - positive would be if this didnt happen |
|
Definition
|
|
Term
| dx of Achilles tendon rupture |
|
Definition
|
|
Term
| where does the achilles tendon rupture |
|
Definition
| 4-6cm proximal to its insertion on the calcaneus at the WATER SHED AREA (poor blood supply) |
|
|
Term
surgical repair
-repair end to end, fascial graft |
|
Definition
|
|
Term
Non surgical repair
-cast in equinas (plantar flexed position) |
|
Definition
|
|
Term
| complication to achilles tendon rupture surgery |
|
Definition
| injury to the sural nerve |
|
|
Term
-pain in mid to upper medial calf
-forceful plantar flexion of foot with knee extended
-mimics DVT
-Thompson test causes sig pain |
|
Definition
| Tennis leg or Medial Gastroc Muscle Tear |
|
|
Term
-RICE
-splint
-NWB w crutches
-NEVER surgical |
|
Definition
| Tennis Leg or Medial Gastroc Muscle Tear |
|
|
Term
forceful heel strike
avulsion of the achiles tendon |
|
Definition
|
|
Term
| Lower back pain can be associated with |
|
Definition
|
|
Term
-no one recovers completely
-workmans compensation for rest of life
-sometimes a blowout |
|
Definition
|
|
Term
| Calcaneus fx can be associate with |
|
Definition
| compression fx of the vertabrae |
|
|
Term
| calcaneus fx can be presented with |
|
Definition
|
|
Term
|
Definition
|
|
Term
-repeticive heel strike during running and jumping
-repetitive traction thru achilles tendon |
|
Definition
| Calcaneal apophysitis (Sever's disease) |
|
|
Term
| inclammation of the apophysitis of the os calcis w or wo fragmentation of the apophysis |
|
Definition
| Calcaneal apophysitis (Sever's disease) |
|
|
Term
heel pain during running/walking
swelling
pain tendernss
dec ROM for tight achilles tendon |
|
Definition
| Calcaneal apophysitis (Sever's disease) |
|
|
Term
| longitudinal growth of a long bone |
|
Definition
|
|
Term
| growth center that does not create longitudinal growth |
|
Definition
|
|
Term
-goes away when growth plate fuses
-activity modification
-shoes
-NWB |
|
Definition
| Calcaneal apophysitis (Sever's disease) |
|
|
Term
repetitive dorsi/plantar flexion of the ankle with friction/traction exerted thru the achilles tendon
-direct pressure (shoe fit) |
|
Definition
|
|
Term
-inflammation of the retrocalcanea and or the retroachilles bursa
-may b with or without the callus formation "pump bump" |
|
Definition
|
|
Term
| retrocalcaneal bursitis or subcutaneous calcaneal bursitis can cause |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| tx for retrocalcaneal bursitis but rarely indicated |
|
|
Term
-Acquired flat foot
-underdiagnosed/unrecognized
-middle aged pt (F>M) |
|
Definition
| Posterior Tibial Tendon Insufficiency |
|
|
Term
-pain/swelling along inside of ankle
-loss of arch
-weakness/inability to stand on toes
-valgus ankles |
|
Definition
| Posterior Tibial Tendon Insufficiency |
|
|
Term
|
Definition
| Posterior Tibial Tendon Insufficiency |
|
|
Term
|
Definition
| tx for Posterior Tibial Tendon Insufficiency |
|
|
Term
Deviation from this:
-Lateral view: first metatarsal should line up with the navicular and talus
-Superior view: navicular head and talus should be parallel |
|
Definition
| Posterior Tibial Tendon Insufficiency |
|
|
Term
| repetitive heel strike while running on hard surfaces, poor fitting shoes |
|
Definition
|
|
Term
| Compression of the posterior tibial nerve in the posteriomedial compartment of the ankle |
|
Definition
|
|
Term
| Postive Tinel sign will give you dx at tib posterior |
|
Definition
|
|
Term
inj
decompression surgery
orthotis |
|
Definition
|
|
Term
Distinct lesion +/- detachment of articular cartilage from subchondral bone forming a loose body
Secondary to trauma |
|
Definition
|
|
Term
acute inversion injury
feelings of instability and give away episodes |
|
Definition
|
|
Term
| MRI is modality of choice |
|
Definition
|
|
Term
| talar neck fx w no displacement |
|
Definition
|
|
Term
| talar neck fx w minimal displacement |
|
Definition
|
|
Term
| talar neck fx with sig displacement and posterior dislocation and twisting of the talus |
|
Definition
|
|
Term
| Osteopenia seen beneaththe subchondral surfacce of the talar dome, occurs after fx, sign of revascularization |
|
Definition
|
|
Term
| Tx for type 1 Hawkins talar neck fx |
|
Definition
| non operative, NWB in cast |
|
|
Term
| Tx for types 2-4 hawkins talar neck fx |
|
Definition
|
|
Term
| Lateral Process Fracture of Talus |
|
Definition
|
|
Term
| created by forced dorsiflextion and external rotation of the foot |
|
Definition
| lateral process fx of the talus (Snowboarder's fx) |
|
|
Term
|
Definition
| lateral process fx of the talus (Snowboarder's fx) |
|
|
Term
-repetitive traction
-pain on dorsiflexion with reduced dorceflexion |
|
Definition
| anterior impingement syndrome |
|
|
Term
-congenital or acquired
-talar spur (trigonal process) or seperate un-united ossification center of the talus (OS trigonum)
- ballet, cricket, bowlers, jumpers, swimmers |
|
Definition
| Posterior impingement syndrome |
|
|
Term
repetitive stress (traction) during weight bearing and or push off
-risk: rigid pes cavus, short achilles tendon, activity level, weight
-microtrauma, inflammation |
|
Definition
|
|
Term
|
Definition
|
|
Term
| -morning pain (first few steps extreemely painful |
|
Definition
|
|
Term
|
Definition
|
|
Term
Localized pain and tenderness during passive hyperextension of MP joints
Point tender at calcaneal insertion (calcaneal spur)
Tightness of achilles tendon on affected side |
|
Definition
|
|
Term
| dorsiflex foot, hyperextend toes, and press on calcaleal insertion on bottom of foot |
|
Definition
|
|
Term
| positive windless mechanism |
|
Definition
|
|
Term
stretching
night splints
orthotics
ultrasound therapy
inj
surgical |
|
Definition
|
|
Term
-Repetitive stress (running, jumping, ballet)
-osteoprosis
-obesisty
-abnormal foot structure or mechanices |
|
Definition
|
|
Term
| stress fx of the neck or shaft of the metatarsals - 2nd 3rd or 4th |
|
Definition
|
|
Term
| 50% of weight is beared by what part of the foot? how is this clinically significant? |
|
Definition
| the first metatarsal, if you have flat feet more of the weight is beared by the lesser tarsals |
|
|
Term
-Metatarsalgia
-gradual onset
-sharp point tenderness worse with walking
-diffuse swelling |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Base of 5th metatarsal fx at the metaphyseal diaphyseal junction |
|
Definition
|
|
Term
| fx located within1.5cm distal to tuberosity of 5th metatarsal |
|
Definition
|
|
Term
Due to poor blood supply in this area high incidence of non healing fracture called non-union
Non-wt-bearing cast for 6 – 8 + wks is necessary for healing
If chronic / non-union, will need surgical intervention |
|
Definition
|
|
Term
fx dislocation injury of of the tarsal / metatarsal joint
complex injuty that is oftent missed
initial xrays mary show minimal displacemtn but severe ligamentous injury may exist |
|
Definition
|
|
Term
| this joint is key to the arch of the foot |
|
Definition
|
|
Term
-Direct (dorally applied force (crush injury))
-Indirect (axial load and twist on a plantar flexed foot) |
|
Definition
|
|
Term
| dorsally dislocation of the second metatarsal |
|
Definition
|
|
Term
| tenderness with passive abduction and pronation of forefoot while holding the hind foot fixed |
|
Definition
|
|
Term
| avulsion of the lisfranc ligament off of the 2nd metatarsal base |
|
Definition
|
|
Term
| widening of more than 2-3mm bw 1st /2 nd metatarsals then you have |
|
Definition
|
|
Term
| Fibrous enlargement of a plantar interdigital nerve with entrapment between metatarsal heads (usually 3rd and 4th ) |
|
Definition
|
|
Term
Direct trauma (stretching of plantar structures during hyperextension of the MP joint (sprint starts, recovery from jump)
Tight shoes, lateral compression of metatarsal heads and interdigital nerves |
|
Definition
|
|
Term
Pain in the web space
Loss of sensation
cramp-like pain during running
Tingling/numbness in lateral third and medial 4th toes
Pain / pressure relief on removal of shoe
point tenderness in webspace
Callus
positive compression test may have (clicking) |
|
Definition
|
|
Term
Pain and tenderness at intermetatarsal interspae
dec sensation |
|
Definition
|
|
Term
Thumb and index palpate interspace
Opposite hand compresses transverse arch
Palpable click as nerve passes over transverse metatarsal ligament |
|
Definition
|
|
Term
orthotics
metatarsal neck pad
local inj
surgery for refractory cases |
|
Definition
|
|
Term
Big toe (hallux) deviates toward direction of the little toe
As big toe drifts into valgus, a bump starts to develop on the inside of the big toe over the metatarsal |
|
Definition
|
|
Term
Hereditary Cause
Aggravated by shoe wear |
|
Definition
|
|
Term
In reality can treat in two ways:
(1) change the size & shape of the shoe
Avoid narrow toe box
Orthotics
(2) change the size & shape of the foot
Surgical (cosmesis) |
|
Definition
|
|
Term
Pain over dorsal PIP joint
Plantar flexed PIP only
May be associated with hallux valgus |
|
Definition
|
|
Term
Pain over dorsal DIP joint and/or distal tip
Plantarflexion deformity of DIP
12% of mallet toes have associated medial or lateral deviation
2nd and 3rd toe most commo |
|
Definition
|
|
Term
|
Definition
|
|
Term
| deformities of the fifth toe are generally |
|
Definition
|
|
Term
callosity overlying a boney prominence
Dorsolateral aspect of the 5th toe
Interdigital space between 4th and 5th toe
Distal tips |
|
Definition
|
|
Term
| avascular necrosis of the lesser metatarsal heads |
|
Definition
|
|
