Foot Deformities Lecture Notes PDF

Foot Deformities We'll explore the complex anatomy of the foot and the muscles that power its intricate movements. This presentation will delve into the bony structures, intrinsic and extrinsic muscles, and the actions they perform....

Foot Deformities We'll explore the complex anatomy of the foot and the muscles that power its intricate movements. This presentation will delve into the bony structures, intrinsic and extrinsic muscles, and the actions they perform. Dr Mohamed Nabil, MD. preencoded.png  Introduction to the Foot The Foundation Key Functions The foot is a complex structure serving as the foundation for human It absorbs shock, adapts to uneven terrain, and helps maintain body movement. It allows us to walk, run, jump, and balance. body posture. preencoded.png  Bony Structures of the Foot Tarsals Metatarsals Seven bones forming the foot's base, Five long bones connecting the base, including the calcaneus (heel tarsals to the phalanges. (heel bone) and talus (ankle bone). bone). Phalanges The bones of the toes, with two in the big toe and three in each of the other toes. other toes. preencoded.png  Foot Arches Longitudinal Arch Transverse Arch Arch Variations The longitudinal arch runs along the length of The transverse arch runs across the foot, just Foot arches can vary in height and shape. Flat length of the foot, from heel to toes, and helps just behind the toes, and helps to maintain the Flat feet have lower arches, while high arches helps to absorb shock and distribute body maintain the foot's shape and stability. arches are more pronounced. body weight. preencoded.png  Intrinsic Foot Muscles Dorsiflexors Plantarflexors Muscles on the dorsum of the foot that Muscles on the back of the foot that that lift the foot. point the toes down. Inversion Muscles Eversion Muscles Muscles that turn the sole of the foot Muscles that turn the sole of the foot foot inwards. foot outwards. preencoded.png  Muscles Acting on the foot 1 Gastrocnemius & Soleus A powerful plantarflexors and form achillis tendon 2 Tibialis Anterior A muscle that dorsiflexes and inverts the foot. 3 Tibialis posterior Plantar flexion. inversion 4 Flexor \ Extensor Digitorum toes flex \ ext 5 Peroneus longus support arch 6 Peroneus brevis Eversion preencoded.png 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. preencoded.png preencoded.png preencoded.png  Foot Position During the Gait Cycle Heel Strike Foot Flat Midstance Heel Off Initial heel contact; plantar flexors engage. Full foot contact; ankle dorsiflexors activate. Weight shifts to midfoot; stable foot Heel lifts; ankle dorsiflexors engage. engage. activate. position. Toe Off Toes push off; plantar flexors engage. preencoded.png  Flexibile or Rigid 1 2 Flexibility Rigid The ability to correct the deformity. fixed deformity soft tissue contracture, ms imbalance usually bony deformities imbalance need corrective osteotomies soft tissue release, tendon transfer preencoded.png  Conclusion and Key Takeaways Takeaways Understanding the foot's anatomy, especially the muscles, is crucial for maintaining optimal foot health and function. Proper foot care, including exercises and stretching, can help prevent injuries and improve overall mobility. preencoded.png  Muscle Imbalances Tight Calf Muscles Weak Intrinsic Muscles Overpronation Overly tight calf muscles can limit ankle Insufficient strength in intrinsic foot muscles Excessive inward rolling of the foot during gait dorsiflexion, impacting gait and potentially can compromise arch support and increase the during gait can strain muscles and ligaments, potentially leading to injuries. risk of foot problems. ligaments, potentially leading to conditions like conditions like plantar fasciitis. preencoded.png  Biomechanics of the Foot Foot biomechanics encompasses the study of forces and movements during walking, running, walking, running, and other activities. Understanding foot biomechanics is essential for diagnosing and treating foot conditions, conditions, designing footwear, and enhancing athletic performance. A key concept in foot biomechanics is the "tripod" of the foot. This refers to the three points of contact that the foot makes with the ground during weight-bearing: the heel, the first metatarsal head (under the big toe), and the fifth metatarsal head (under the little toe). These three points form a stable base of support, allowing the foot to distribute weight evenly weight evenly and efficiently. The distribution of weight across the tripod is influenced by influenced by factors such as foot structure, muscle strength, and the type of surface being surface being walked on. Proper alignment and function of the tripod is critical for maintaining balance and preventing injuries. Imbalances in the tripod can contribute to various foot conditions. preencoded.png  Common Foot Conditions Various conditions can affect the feet, impacting comfort and mobility. These conditions range from mild to severe, and understanding them is crucial for crucial for proper treatment. preencoded.png  Tip-Toeing and Equinus Tip-Toeing Walking on the toes, known as tip-toeing, is a common movement for children but may be an indicator of underlying foot conditions in adults. Equinus Equinus refers to a limited ability to dorsiflex the ankle, where the foot remains pointed downward. This often involves tight calf muscles and can lead to tip-toeing. Potential Causes Equinus can be habitual or caused by conditions like Cerebral Palsy, muscular dystrophy, or simply tight calf muscles. Tight achiliis or Gastrocnemius silverskoild test preencoded.png silverskoild test Dorsiflexion with knee extended Dorsiflexion with knee flexed if increased === tight GC preencoded.png  Pes Cavus Pes cavus, also known as high arch foot, is a condition characterized by an abnormally high arch. This condition can be caused by various factors, including genetics, neurological neurological disorders, and muscle imbalances. preencoded.png  Heel Varus Heel varus, also known as inward heel, is a foot condition characterized by a turned-in turned-in heel. This inward tilt can impact gait and potentially lead to discomfort or pain. preencoded.png  Equinocavovarus Equinocavovarus is a complex foot deformity characterized by a combination of equinus (limited ankle dorsiflexion), cavus (high arch), and varus (inward-turned heel). This condition can significantly impact gait, leading to altered stride patterns and patterns and potential discomfort or pain. preencoded.png  Pes Planovalgus (Flatfoot) Pes planus, commonly known as flatfoot, refers to a condition where the arch of the foot is flattened. This can be a congenital condition present from birth or develop over time due to due to various factors like obesity, overuse, or underlying medical conditions. conditions. planus + heel valgus + forefoot Abd + pronation preencoded.png forefoot abduction heel valgus pes planus too many toes sign loss of arch , pronation preencoded.png  Hallux Valgus Hallux valgus, also known as bunion, is a condition where the big toe deviates towards the other toes. This misalignment can lead to a bony bump on the inside of the foot. Hallux valgus often causes pain, inflammation, and difficulty wearing shoes. Factors like genetics, foot structure, and excessive pressure on the toes can contribute to this condition. Treatment options range from supportive footwear and padding to surgery. preencoded.png preencoded.png  Hallux Varus Hallux varus is a less common condition affecting the big toe, where it deviates inward deviates inward towards the other toes. It can cause pain, difficulty walking, and and problems with footwear. congenital. ms imbalance, bony deformity. orthosis, P.T\ surgerical preencoded.png  Hallux Rigidus Hallux rigidus is a painful condition that affects the big toe joint. This condition restricts movement of the big toe joint, leading to stiffness and pain. Dorsal bunion preencoded.png  Clubfoot (congenital TEV) Clubfoot is a birth defect that affects the shape of a child's foot. The foot is turned inward and downward, resembling a golf club. This occurs due to abnormal development of the foot's muscles, tendons, and bones. Cavus, Equinus, forefoot adduction, supination, Heel varus Serial casting — soft tissue release — Osteotomies preencoded.png preencoded.png  Vertical Talus Vertical talus, also known as congenital vertical talus, is a rare but severe foot deformity present at birth. It is characterized by the talus bone, located in the ankle, being positioned vertically rather than its usual horizontal orientation. This abnormal alignment affects the foot's structure and function, making it difficult to walk and stand. The foot is often rigid and cannot be easily moved into a normal position. preencoded.png  talonavicular dislocation Rocker buttom deformity preencoded.png  Toe Deformities Toe deformities are common conditions that affect the shape and alignment of the toes. These deformities can cause pain, discomfort, and difficulty walking. preencoded.png  Toe Deformities: Understanding, Treating, and Preventing This presentation will discuss common toe deformities, their causes, symptoms, diagnosis, and treatment options. We'll also explore ways to prevent and manage these conditions. Dr. Mohamed Nabil, MD preencoded.png  Types of Toe Deformities Hammer toe Bunion claw toe Crossover Toe extension MTP & flexion in PIP. A bony bump forms on the big toe Hyperextension MTP & flexion IP. The second toe crosses over the big toe joint, causing pain and flexion IP. big toe, often causing pain and shoe-fitting issues. calluses. dorsal — hallux rigidus medial — hallux valgus preencoded.png  Causes of Toe Deformities 1 Genetics 2 Acquired Conditions Certain genetic predispositions can increase the risk of Conditions like arthritis, diabetes, and nerve disorders can lead to developing toe deformities. can lead to toe deformities. 3 Trauma 4 Footwear Injuries to the toes, such as fractures or sprains, can cause lasting Tight or ill-fitting shoes can contribute to the development of toe cause lasting deformities. development of toe deformities over time. preencoded.png  Symptoms and Diagnosis Pain Inflammation Pain and discomfort, especially when Redness, swelling, and tenderness in the when wearing shoes. affected toe. Deformity Calluses Visible changes in the shape and Calluses or corns may develop due to alignment of the toes. to pressure from the deformed toe. preencoded.png  Non-Surgical Treatment 1 Conservative Treatment Includes padding, taping, and orthotics to support the toes and reduce pressure. 2 Medications Over-the-counter pain relievers and anti-inflammatories can help manage discomfort. discomfort. 3 Injections Corticosteroid injections can temporarily reduce inflammation and pain. 4 Shoe Modifications Wearing wider shoes with supportive insoles can help minimize discomfort. preencoded.png Surgical Interventions Osteotomy Involves cutting and repositioning bones to realign the toe. Tendon Transfer Moving tendons to improve toe function and stability. Joint Fusion Fusing toe joints to correct deformities and reduce pain. preencoded.png