Foot Deformities Overview

Foot Deformities Overview

• Foot deformities involve complex anatomy of the foot and its muscles
• The presentation covers bony structures, intrinsic and extrinsic muscles, and their functions.

Introduction to the Foot

• The foot is a complex structure foundational to human movement
• It allows for walking, running, jumping, and maintaining balance
• Key functions include shock absorption, adapting to uneven terrain, and maintaining body posture.

Bony Structures of the Foot

• Tarsals: Seven bones forming the foot's base, including the calcaneus (heel bone) and talus (ankle bone)
• Metatarsals: Five long bones connecting the tarsals to the phalanges
• Phalanges: The bones of the toes, with two in the big toe and three in each of the other toes.

Foot Arches

• Longitudinal Arch: Runs along the length of the foot (heel to toes) absorbing shock and distributing body weight.
• Transverse Arch: Runs across the foot, just behind the toes, maintaining foot shape and stability
• Arch Variations: Foot arches vary in height and shape. Flat feet have lower arches, and high arches are more pronounced.

Intrinsic Foot Muscles

• Dorsiflexors: Muscles on the dorsum (top) of the foot that lift the foot
• Plantarflexors: Muscles on the back of the foot that point the toes down
• Inversion Muscles: Muscles that turn the sole of the foot inwards.
• Eversion Muscles: Muscles that turn the sole of the foot outwards.

Muscles Acting on the Foot & Leg Muscles

• Specific muscles detailed with actions like: dorsiflexion, plantar flexion, inversion, and eversion
• Muscles listed: Gastrocnemius, Soleus, Tibialis Anterior, Tibialis posterior, Flexor/Extensor Digitorum, Peroneus longus, Peroneus brevis
• Image diagrams for clarification on action and location

Muscle Actions on the Foot

• Dorsiflexion: Lifting the foot upwards
• Plantarflexion: Pointing the toes downwards
• Inversion: Turning the sole of the foot inwards
• Eversion: Turning the sole of the foot outwards

Gait Cycle

• The presentation includes diagram stages: Loading Response, Mid Stance, Terminal Stance, Pre Swing
• Images demonstrating specific actions within the gait cycle like Heel Strike, Foot Flat, Heel Off, Toe Off

Foot Position During the Gait Cycle

• The gait cycle stages detailed with the points of contact of the foot with the ground at each stage (Heel Strike, Foot Flat, Midstance, Toe Off, Heel Off)

Flexible or Rigid

• Flexibility: The ability to correct the deformity. Soft tissue contracture can be corrected with soft tissue releases, or tendon transfer.
• Rigidity: A fixed deformity that may require corrective osteotomies.

Conclusion and Key Takeaways

• Understanding foot anatomy, especially muscles, is crucial for maintaining optimal foot health and function.
• Proper foot care (exercises, stretching) helps prevent injuries and improves mobility.

Muscle Imbalances

• Tight Calf Muscles: Limiting ankle dorsiflexion, impacting gait, and leading to possible injuries.
• Weak Intrinsic Muscles: Insufficient strength in intrinsic foot muscles. This can be problematic in supporting the arch, compromising stability, and increasing foot problems
• Overpronation: Excessive inward rolling of the foot during gait can strain muscles and ligaments, leading to conditions like plantar fasciitis.

Biomechanics of the Foot

• Foot biomechanics studies forces and movements during various activities (walking, running).
• Understanding foot biomechanics is essential for diagnosing and treating conditions, designing footwear and enhancing athletic performance.
• The "tripod" concept is key (heel, first metatarsal head, fifth metatarsal head). This evenly distributes weight during weight bearing.

Common Foot Conditions

• Conditions listed and shown in illustrations.
• Conditions such as Talipes Equinus, Talipes Calcaneus, Talipes Cavus; and Talipes Varus; and Talipes Equinovalgus
• Talipes Calcaneovarus and more.

Tip-Toeing and Equinus

• Tip-toeing (walking on toes) is a common characteristic movement pattern for children, but may also be an indicator of underlying conditions in adults.
• Equinus limits dorsiflexion (ability to lift foot), stemming mainly from tight calf muscles.

Silverskoild Test

• A clinical test to assess dorsiflexion of the ankle that can help determine if calf muscles are tight.

Pes Cavus

• Condition characterized by an abnormally high arch. This is often due to genetic predispositions, neurological disorders, or muscle imbalances.

Heel Varus

• Foot condition characterized by a turned-in heel
• Can influence gait and lead to discomfort or pain
• Illustrations of variations shown.

Equinocavovarus

• Characterized by equinus, cavus and varus, which involve a combination of limited dorsiflexion, high arch, and inward-turned heel.

Pes Planovalgus (Flatfoot)

• A condition where the arch of the foot is flattened.
• This can range from congenital to developed over time due to genetics, obesity, overuse or underlying medical conditions.
• There is a diagram for illustrations of flexible and rigid flatfoot.

Forefoot Abduction, Heel Valgus

• Forefoot abduction is abnormal outward rotation of the forefoot and Heel valgus is abnormal inward tilt of the heel. This impacts the normal gait cycle.
• Charts for illustrating the differences in normal, over pronation and over supination.

Hallux Valgus

• Big toe deviates toward the other toes.
• Causes bony bump on the inside of the foot, pain, inflammation, and difficulty wearing shoes.
• Factors such as genetics, structure, and pressure can contribute to this condition..

Hallux Varus

• Less common condition affecting the big toe where it deviates inward toward the other toes.
• Difficulty walking, pain from footwear issues.
• Several factors lead to this like congenital conditions, bony deformities and muscle imbalance.

Hallux Rigidus

• Painful condition affecting the big toe joint and makes it hard to move the big toe
• Restricting big toe movement often causes pain and stiffness of that big toe joint.
• Diagram shown.

Clubfoot (Congenital TEV)

• Birth defect affecting the foot's shape resulting in inward and downward turn
• Due to abnormal development of muscles, tendons and bones.
• Treatments such as serial casting, soft tissue release and osteotomies outlined.

Vertical Talus

• Rare but severe foot deformity present at birth where the talus bone is positioned vertically instead of horizontally
• This affects the foot's structure and function
• The foot is often rigid and cannot be easily moved into a normal position.

Rocker Bottom Deformity

• Characterized by an unusual shape in the foot.

Toe Deformities

• Common conditions affecting toe shape and alignment
• Can cause pain, discomfort, and difficulty walking.

Toe Deformities: Understanding, Treating, and Preventing

• Presentation covering causes, symptoms, diagnosis, and treatment options for common toe deformities.
• The prevention and management of these conditions is part of the content

Types of Toe Deformities

• Hammer toe: Extension MTP & flexion in PIP
• Bunion: A bony bump on the big toe joint causing pain and shoe-fitting issues.
• Claw toe: Hyperextension MTP & flexion IP.
• Crossover Toe: The second toe crosses over the big toe, causing pain and calluses.

Causes of Toe Deformities

• Genetics: Certain genetic predispositions increase risk.
• Acquired conditions: Arthritis, diabetes, nerve disorders can lead to toe deformities.
• Trauma: Injuries such as fractures or sprains can cause lasting deformities.
• Footwear: Ill-fitting shoes can contribute to development.

Symptoms and Diagnosis

• Pain: Discomfort, especially when wearing shoes
• Inflammation: Redness, swelling, tenderness in affected toe
• Deformity: Visible changes in shape and alignment of toes
• Calluses: Develop due to pressure from deformed toe.

Non-Surgical Treatment

• Conservative treatment: Includes padding, taping, orthotics to support the toes and reduce pressure.
• Medications: Over-the-counter pain relievers and anti-inflammatories to manage discomfort.
• Injections: Corticosteroid injections can temporarily reduce inflammation and pain.
• Shoe modifications: Wearing wider shoes with supportive insoles to minimize discomfort

Surgical Interventions

• Osteotomy: Cutting and repositioning bones to realign the toe.
• Tendon Transfer: Moving tendons to improve function and stability.
• Joint Fusion: Fusing toe joints to correct deformities and reduce pain.

Explore the complex anatomy of the foot, including its bony structures and muscle functions. This quiz covers essential aspects such as foot deformities, arches, and key functions that influence movement and balance.