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Applied anatomy and surgical approaches
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
Rajeev Vohra, Babaji Sitaram Thorat, Avtar Singh
The lateral plantar artery passes deep to abductor hallucis and flexor digitorum brevis towards the base of fifth MT and then curves medially to create the deep plantar arch. At the proximal end of the first intermetatarsal space it anastomoses with the deep plantar artery which is a branch of the DPA (Figure 2.5). Four MT arteries arise from the convexity of the arch, which divides further into a pair of plantar digital arteries supplying the foot webs and adjacent toes. The medial plantar artery runs deep to abductor hallucis and then between it and flexor digitorum brevis to reach the medial border of the hallux. It supplies muscles of the hallux and skin on the medial aspect of the sole (Figure 2.5).
Dermatophytic onychomycosis
Published in Archana Singal, Shekhar Neema, Piyush Kumar, Nail Disorders, 2019
Malcolm Pinto, Manjunath M. Shenoy
Superficial Onychomycosis: Superficial onychomycosis (SO) is a rare, distinctive pattern of OM in which the upper surface of the nail plate is the primary site of invasion. Superficial white OM (SWO) mainly involves toenails and T. mentagrophytes var. interdigitale is responsible for more than 90% of cases. Clinically, there is presence of small, well-delineated opaque white islands on the dorsal nail plate that coalesce, resulting in a rough, soft, crumbly chalky white appearance to the entire nail surface—hence, the term leukonychia trichophytica. SWO usually affects a single toenail and may show a diffuse involvement of the nail both in width and depth. T. mentagrophytes var. interdigitale infections present with rather pruritic, vesicular eruption affecting the plantar arch and sides of the foot and heel accompanied by SWO.5 Superficial black onychomycosis (SBO) due to Neoscytalidium dimidiatum on dermoscopy reveals a granular pattern with scalloped border.
Lower Limb
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
Two fibular muscles make up the lateral compartment of the leg: the fibularis longus more laterally and fibularis brevis more medially (Plate 5.12). As these muscles pass lateral to the ankle joint, they logically evert the foot, and although they derive evolutionarily and developmentally from an ancestral/common extensor group, as noted above, they actually flex (plan-tarflex) the foot. As its name indicates, the fibularis longus is longer than the fibularis brevis. It originates more proximally from the fibula than the fibularis brevis—and distally—it passes with the brevis deep to the superior and inferior lateral retinacula and then continues all the way through the plantar surface of the foot to insert onto metatarsal 1 and the medial cuneiform (the fibularis brevis inserts onto metatarsal 5). Therefore, apart from everting and flexing (plantarflexing) the foot, the fibularis longus also supports the plantar arches of the foot.
Horizontal Heterophoria Modifications by Means of Thin Proprioceptive Stimulations Applied on the Foot Sole: A Randomised Study
Published in Journal of Motor Behavior, 2022
Finally, thin somatosensory stimulations on the plantar arches were already used in previous articles (Alessandria & Gollin, 2020; Foisy et al., 2015; Foisy & Kapoula, 2017; Janin & Dupui, 2009; Tramontano et al., 2019) which base their hypotheses on the concepts of classical posturology according to Bricot (2011). In contrast to the hypotheses of Bricot (2011), that suggest an action of muscle stimulation due to the thin plantar insert, other authors indicate an action of stimulation of cutaneous mechanoreceptors of the plantar arches (Janin & Dupui, 2009), with consequent neuromuscular responses and modification of the pressure on the plantar arches (Aminian et al., 2013; Forth & Layne, 2007, 2008). The same authors, though studying different postural effects of these types of thin podalic stimulations, agree that they are enough to produce functional changes on the postural organisation and that they are simple to manage in the creation of proprioceptive insoles, without causing discomfort in the subjects who wear them.
Successful treatment of medial tibial stress syndrome in a collegiate athlete focusing on clinical findings and kinesiological factors contributing to pain
Published in Physiotherapy Theory and Practice, 2022
Given the limited evidence from the literature regarding treatment protocols, the therapist proposed that in order to address the causative factors contributing to the patient’s pain the intervention plan needed to address the clinical and kinesiological findings from the examination. Treatment focused on setting goals according to the physiotherapeutic assessment findings. The following treatment objectives were established: 1) Increase dorsiflexion and eversion range of motion (ROM), by eliminating taut bands of the gastrocnemius and the anterior tibialis, calf muscle stretching, strengthening of anterior tibialis, passive ankle mobilizations with traction, and reducing fascial restrictions of the posteromedial leg; 2) Correct ankle valgus and fallen longitudinal plantar arch, by strengthening the posterior tibialis; and 3) Return to sport activities.
Ultrathin free flaps for foot reconstruction: impact on ambulation, functional recovery, and patient satisfaction
Published in Journal of Plastic Surgery and Hand Surgery, 2021
Beatriz Hatsue Kushida-Contreras, Miguel Angel Gaxiola-García
We registered objective assessments during scheduled follow-up visits on an outpatient basis. No patient presented plantar ulceration during the physical exam. The plantar arch was preserved in all but two patients; in these cases, some bulkiness was noted in the flap but with no indication for further thinning, both patients were using regular shoes. Eleven out of twelve patients reported deep sensation after monofilament testing; protective sensation was present in 9 of 12 patients (75%). Ten patients were using normal footwear regularly (usually sneakers), one patient was using slippers and another patient was using insoles by choice, i.e. not prescribed by a podiatrist. The whole group of patients was satisfied with the procedure. Two of the patients presented with melanoma-associated vitiligo, now recognized to associate with favorable outcomes [30], see Table 2.