The Medical clinics of North America
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Achilles tendon disorders include tendinosis, paratenonitis, insertional tendinitis, retrocalcaneal bursitis, and frank rupture. Patients present with pain and swelling in the posterior aspect of the ankle. ⋯ Surgical treatment includes debridement of the diseased area of the tendon with direct repair. Tendon transfer may be necessary to augment the strength of the Achilles tendon.
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Evaluation of gait and its associated deviations from normal requires an in-depth evaluation of the patient and an appreciation for the complexity of the task. Understanding gait starts with an appreciation of the basic determinants of gait. Foot drop is a common gait deviation. ⋯ This will result in alterations of the gait cycle during swing phase. The common compensations for a foot drop include steppage gait, circumduction, and a persistently abducted limb. Noninterventional options for management of common gait deviations secondary to ankle/foot dysfunction present challenges.
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Ankle injuries are among the most common injuries presenting to primary care providers and emergency departments and may cause considerable time lost to injury and long-term disability. Inversion injuries about the ankle involve about 25% of all injuries of the musculoskeletal system and 50% of all sports-related injuries. ⋯ High ankle sprains occur less frequently in the general population, but do occur commonly in collision sports. Providers should apply the Ottawa ankle rules when radiography is indicated and refer fractures and more severe injuries to orthopedic surgery as needed.
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Med. Clin. North Am. · Mar 2014
ReviewMetatarsalgia, lesser toe deformities, and associated disorders of the forefoot.
Forefoot pain in the adult often alters mobility and has a negative impact on quality of life. Metatarsalgia describes pain localized to the forefoot. ⋯ In addition to lesser toe and metatarsal abnormality, forefoot pain can be attributed to interdigital neuritis, disorders of the plantar skin, and gastrocsoleus contracture. Treatment of these conditions may include shoe modifications, appliances, therapeutic exercises, and surgical repair.