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Soft-tissue knee problems These can present as acute injures or as delayed, more chronic cases with additional degenerative problems. Specific structures commonly involved are the menisci, ligaments and tendons. These can also be associated with chondral or ost...

ANATOMY There are 26 (25 with variant) main bones in the foot (seven tarsal bones, five metatarsals and 14 phalanges [13 in the biphalangeal fifth toe variant]) plus the two sesamoids of the hallux and a variable number of other sesamoid and accessory bones. M...

Acquired flat foot There is a wide range of normal appearance of adult feet. Pathological causes of a flat foot include: /uni25CF tibialis posterior tendon dysfunction; /uni25CF tarsometatarsal arthritis/injury ( Figure 41.8 ); /uni25CF Charcot neuroarthropat...

Ankle instability ); Most people who sustain an ankle sprain will recover, partic - - ularly if they receive prompt physiotherapy . However, some individuals develop significant instability . On examination an unstable ankle due to ligament disruption will sho...

BIOMECHANICS The walking cycle is divided into the stance (60%) and swing (40%) phases. The stance phase is divided into three intervals: (i) heel strike to foot flat; (ii) foot flat until the body passes over the ankle; and (iii) ankle joint plantarflexion to to...

Charcot Charcot is a condition in which patients develop a neuropathic destruction of the joints. It is often described as painless but - - - (b) Figure 41.12 Charcot foot: radiographs taken at the time of a trivial injury (a) and 6 weeks later (b) . Figure 4...

Diabetes Patients with diabetes have foot problems secondary to neuro pathy and microvascular changes. They are at increased risk of infection and ulceration, and trauma (sometimes trivial) can lead to collapse of the foot, also known as Charcot neuro arthro...

Examination The examination of the foot is described in Chapter 35 patient should be watched walking, and both the foot and the footwear of the patient need examining when looking for abnormal load and wear. Examination The examination of the foot is describe...

FURTHER READING Bulstrode C, Wilson MacDonald J et al . Oxford textbook of trauma and orthopaedics , 2nd edn. Oxford: Oxford University Press, 2017. Miller MD, Thompson SR. Miller’s review of orthopaedics , 8th edn. Philadelphia, PA: Elsevier, 2019. Warwick ...

Hallux rigidus erload Hallux rigidus is a painful condition of the hallux MTP joint characterised by loss of motion, especially in dorsiflexion, and osteophyte formation on the dorsum and sides of the joint ( Figure 41.4 ). Hallux valgus /uni25CF /uni25CF /un...

Heel pain The commonest cause of heel pain is plantar fasciitis. Pain is located inferomedially within the heel and is worst first thing in the morning and after periods of rest. The majority of cases settle within 18 months and surgery is rarely required - or...

Infection Septic arthritis in the foot or ankle is rare except in patients with diabetes and constitutes a surgical emergency; when it occurs it usually follows a surgical procedure but it can also arise as a result of haematogenous spread. Treatment is immed...

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Learning objectives To understand: The basic anatomy and biomechanics of the foot and • ankle The common problems affecting the foot and ankle in • each age group Learning objectives To understand: The basic anatomy and biomechanics of the foot and • ankle The...

Neurological foot conditions Pes cavus The development of unilateral pes cavus is likely to be due to an upper motor neurone lesion, so an appropriate neuro logical examination should be performed and spinal imaging is mandated. Pes cavus is usually bilateral...

Osteochondral lesion of the talus Patients with persistent pain (and sometimes instability) in the - ankle following an injury should be suspected of having an osteochondral lesion, with MRI or CT usually required for diagnosis. Repair of cartilage is not ye...

PAEDIATRIC CONDITIONS These are discussed in Chapter 44 . (b) Figure 41.2 (a, b) Hallux valgus and bunion. PAEDIATRIC CONDITIONS These are discussed in Chapter 44 . (b) Figure 41.2 (a, b) Hallux valgus and bunion. PAEDIATRIC CONDITIONS These are discussed in C...

PATHOLOGY IN THE ADULT The forefoot Hallux valgus Hallux valgus is deviation of the big toe away from the midline, i.e. towards the lesser toes, and is usually associated with a bunion, a swelling made up of both bone and bursa on the 41.2 ). It is medial as...