By Kaj Klaue
This e-book courses the reader on a rational pathway from anamnesis and medical exam (with aiding illustrations), via radiological screening to the perfect surgical resolution. Proposed remedies and therapy effects at approximately 365 days of follow-up are defined intimately by way of intra- and postoperative photos and radiographs. The textual content is restricted to systematic description, and various references are incorporated to the sooner components of the e-book with a view to sincerely hyperlink the preoperative review to the therapy. it really is specific to the surgical correction of foot and ankle pathology that the remedy is sort of consistently "composite" or complicated, in that it involves numerous separate activities. therefore, surgical correction frequently has a number of structural elements (e.g., osteotomy, arthrodesis) and a number of sensible or motor parts. it's the target of the booklet to give an explanation for the impression and motive of each this kind of unmarried “actions”.
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Additional info for The Foot: From Evaluation to Surgical Correction
Concentration of bearing load and callus formation in diabetic patients are considered the precursors to skin breakdown and the appearance of malum perforans. 61 The anterior heel corresponds to the horizontal alignment of all metatarsal heads. This is especially true in weight-bearing conditions (E24). In nonweight-bearing conditions, the horizontal view may demonstrate a convex contour of the plantar skin and hammering of the lesser toes. 63 When the pulps of the toes do not make contact with the ground for a variety of reasons, calluses form beneath the metatarsal heads.
Extension power of the foot is augmented by the long extensors of the hallux and the toes (recruitment). 59 Unloaded alignment Sole of the foot This position corresponds to both the hip and knee being flexed. Any length discrepancy of the thighs is best seen in this position. The patient is asked to hold his or her feet horizontally, and the anatomic horizontal rotation angle between knee and foot axis is assessed (about 15 degrees). Rotation of the lower leg within the horizontal plane is assessed by considering the bicondylar knee and bimalleolar ankle axes With the patient still seated as above and in front of the examiner, the plantar skin is visualized.
With the patient sitting once again, the active mobility of the metatarsophalangeal and both interphalangeal joints are verified in flexion and extension. Functional exam Walking barefoot should always be observed with knees and lower legs visible. All compensation mechanisms appear when both knee joints and feet are observed together. A strong genu varum may be compensated for by a strong hindfoot valgus and/or pronounced external rotation of the feet (E51). This rotational component may be located within the lower leg, and the amount of rotation may be quantified statically (E50).