The cavovarus foot
Maneesh Bhatia in Essentials of Foot and Ankle Surgery, 2021
Orthotics: Insoles in the form of the University of California Berkeley Laboratory (UCBL) shoe insert to maintain the heel in neutral to slight valgus, arch support with a cut-out under the first metatarsal head to allow plantarflexion of the first ray can be used in flexible deformity. A total contact orthosis may help distribute the forces on the forefoot over a larger plantar surface area. This can be improved by adding a metatarsal dome/bar in patients with metatarsalgia symptoms. A lateral hindfoot and midfoot wedge generally helps with symptomatic relief in milder cases. Keeping the lateral side of the post unbevelled provides a more stable platform and improves the resistance of the post to inversion forces. As the deformity worsens, adjustments of the insoles are required as increasing corrective forces are needed. Caution regarding use of strong rigid orthotics in patients with alteration in skin sensation to avoid pressure necrosis. Bracing of the ankle is helpful in patients with chronic ankle instability. Foot drop cases may need an ankle foot orthosis in the form of a foot drop splint.
Foot and ankle disorders
Maneesh Bhatia, Tim Jennings in An Orthopaedics Guide for Today's GP, 2017
Ankle replacement also known as ankle arthroplasty (Figure 8.9): Ankle arthroplasty has become popular in the last few years.3 It helps in preserving movements of the ankle thereby relieving pressure on neighbouring joints as compared to ankle arthrodesis. The modern arthroplasty implants have resulted in improved longitivity and better results. The survivorship of one make of ankle replacements (Hintegra) has been reported to be 84% at 10 years for a group of 684 patients.4 An ideal candidate for ankle replacement is a patient with low functional demand usually greater than 65 years. It can be considered for younger patients with rheumatoid arthritis. The presence of a significant deformity is a contraindication for ankle replacement.
Surgery of the Ankle
Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou in Operative Orthopaedics, 2020
Arthrodesis can be performed arthroscopically (see ‘Ankle arthroscopy’ p. 374) or open. Arthroscopic ankle arthrodesis has been shown to have equivalent union rates with shorter hospital stay; however, it is more difficult to correct deformity. Open ankle arthrodesis is usually via an anterior approach (see ‘Ankle arthroplasty’ p. 371). The lateral transmalleolar approach may be used if soft tissues determine it, or if the subtalar joint is also to be arthrodesed (tibio-talo-calcaneal arthrodesis). Where possible the fibula is preserved for an isolated ankle arthrodesis to provide increased surface and vascularity for fusion and to enable potential conversion to arthroplasty in the future. Internal fixation is with crossed or parallel screws and/or plates for isolated ankle arthrodesis. Screws, plates or intramedullary nails are used for tibio-talo-calcaneal fusion. It is essential to obtain good hold and adequate compression (Figure 13.1). Thorough preparation of all joint surfaces is vital. This is achieved by removal of remaining articular cartilage and exposure of subchondral bleeding cancellous bone to aid biological union.
Finite element analysis of shank and ankle with different boot collar heights in parachuting landing on inversion ground surface
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Chenyu Luo, Tianyun Jiang, Shan Tian, Jie Yao, Yubo Fan
The peak stresses of tibia, fibula, as well as cartilage of ankle joint and subtalar joint were analyzed. The medium collar boots would induce lower peak stress at tibia than the other two cases, while the collar height would not obviously influence the peak stress of fibula. Besides, medium and high collar boots would protect cartilages better compared to low collar boots through reducing peak stress of both ankle joint cartilage and subtalar joint cartilage. Furthermore, the peak forces of lateral ankle ligaments were also analyzed. The lateral ankle ligaments included anterior talofibular ligament, calcaneofibular ligament and posterior talofibular ligament. When landing on inversion ground surface, the ankle performed inversion motion in this simulation, and lateral ankle ligaments would be under damage risk, especially anterior talofibular ligament (Yu et al. 2016). The lateral ankle ligaments were protected best with medium collar boots.
Factors influencing return to play following conservatively treated ankle sprain: a systematic review
Published in The Physician and Sportsmedicine, 2019
Saed A. Al Bimani, Lucy S. Gates, Martin Warner, Catherine Bowen
Inclusion criteria were articles assessing factors that may influence RTP following conservatively treated acute ankle sprain; Any grade of ankle sprain; new and recurrent; athletes practicing any sport activity at any level; any age range; both male and female patients and full text articles published in English from inception until May 2018. Ankle sprain in this review is defined as a traumatic injury that occurred to one or more of lateral ankle ligaments: anterior talofibular ligament, posterior talofibular ligament and calcaneofibular ligament. All types of study designs were considered to be included in this review. Articles were excluded if they did not include time to return to play (TTRTP) as an outcome measure at follow-up assessment and if they included participants following ankle surgery. In this review TTRTP is defined as number of days from injury until an athlete is back to sport activity. Animal and cadaver studies were also excluded.
Effect of inhibitory kinesiotaping on spasticity in patients with chronic stroke: a randomized controlled pilot trial
Published in Topics in Stroke Rehabilitation, 2022
Mahdad Mehraein, Zahra Rojhani- Shirazi, Ahmad Zeinali Ghotrom, Nasrin Salehi Dehno
Taping was employed by a qualified physical therapist in accordance with the recommendations of the Kenzo Kase’s kinesiology taping manual.15 A Y-shaped strip of KT (3NS TEX Tape, 3NS Inc, Korea) was applied to the calf muscles (Gastrocnemius/Soleus) from insertion to the origin of muscles with 25% of its maximal length tension in order to induce inhibitory effect. The basis of Y was anchored on calcaneus without tension with the subject in a prone position with the knee extended and the ankle in a neutral position. Afterward, the ankle was dorsi-flexed and the medial and lateral tails of Y were attached following the soleus muscle and the medial and lateral sides of gastrocnemius muscle.15 During ankle dorsiflexion, the therapist should not provoke spinal reflexes by touching the patient’s sole (Figure 1).
Related Knowledge Centers
- Fibula
- Hinge Joint
- Synovial Joint
- Tibia
- Joint
- Foot
- Leg
- Subtalar Joint
- Inferior Tibiofibular Joint
- Talus Bone