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Toe deformities & gait analysis-LQ
Terms in this set (36)
subtalar supination OKC position
Calcaneal inversion, plantar flexion and adduction
subtalar pronation OKC position
Calcaneal eversion, dorsiflexion and abduction
subtalar supination CKC position
Calcaneal inversion, talar abduction and dorsiflexion
subtalar pronation CKC position
Calcaneal eversion, talar adduction and plantar flexion
two types of hallux valgus
-Congruous Hallux Valgus: joint surfaces still aligned
-Pathologic Hallux Valgus: not aligned, severely angled
at what joint does the adduction in Hallux Valgus occur at?
1st MTP joint
What causes Hallux valgus?
hypermobility/laxity of hallux ligaments
What population is hallux valgus more common in?
-usually due to shoewear
which tendons bowstring and increase lateral displacement of the 1st metatarsal?
Extensor and flexor hallucis longus tendons
Normally what tendon resists the valgus pull of the 1st phalanx?
What other foot compensations go along with hallux valgus?
-lack of DF at the hallux toe is forced to "escape" laterally
What are some common intrinsic/extrinsic factors that would cause hallux valgus?
-narrow toe box
-systemic conditions causing ligamentous laxity
What sport is hallux valgus associated with?
What can be done to fix hallux valgus?
Kalish Bunionectomy; done when the angle is >15 deg
-cut lateral ligaments to release
-shave down bunion
What is the main goal of rehab from a Kalish Bunionectomy?
achieve 50-60 deg of passive hallux DF
Hallux rigidus and hallux limitus
-Hallux rigidus is a hypomobility of the 1st MTP joint while
-hallux limitus is a ankylosing of the 1st MTP joint
-rigidus is a precursor to limitus
Acute Hallux rigidus and hallux limitus
-Adolescents with long narrow, pronated feet.
-More frequent in boys than girls
-Pain and stiffness develops quickly; described as constant, burning, throbbing or aching
-Tenderness to palpate met head
Chronic Hallux rigidus and hallux limitus
-More commonly seen in adults
-Men more frequently than women
-Toe becomes stiff secondarily to OA, pain persists
-Pain at base of big toe while walking
Hallux Rigidus and Hallux Limitus limit what ROM?
inability of 1st MET to PF or DF
-Mirror image of abductvalgus of the 1st MTP joint, but in this case of the 5th MTP
Causes for Tailer's bunions
-Uncompensated forefoot varus
-Congenitally dorsiflexed 5th met
-Congenitally PF 5th met prevents DF
-MTP and DIP are in extension while the PIP is in plantar flexion
Where does the painful callus usually form with hammer toes?
at the tip of the toe
-MTP joint is in extension and DIP and PIP are in flexion
What causes claw toes?
-instability of MTP joints results in malalignment
-During heel-lift and toe off, an increase in activity of flexors overpowers the extensors resulting in the deformity
-The DIP's of one or more toes are in a flexed position
what causes mallet toe?
-Congenital or due to improper shoe wear
Where does the callus form with mallet toes?
-formed at the end of toe
A single gait cycle is known as what?
-Period when 1 foot contacts the ground to when that same foot contacts the ground again
What are the 3 main tasks of gait cycle?
-single limb support
What are the 4 main criteria essential to walking?
During a single stride, what are the 2 periods of double limb support?
-Loading response (right) & Toe Off (left)
-Loading response (left) & Toe Off (right)
go to the ppt to look at specifics of gait mechanics in each phase
Antalgic gait properties
•Decreased stance time on painful leg
•Increased swing time on painful leg
•Decreased swing time on non-painful leg
•Increased stance time on non-painful leg
Trendelenburg gait properties
•Gluteus medius weakness gait
•Lateral trunk lean towards side of weakness
•Maintain body's COG over weak side during stance phase
flexed knee gait properties
-usually in elderly w/ fear of falling
•Flexed trunk posture
•No arm swing
•No initial contact
•No hip extension
•COG stays within BOS
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