Introduction Simple Deformities Deformity Strong Muscle Weak Muscle equinus gastrocnemius-soleus complex dorsiflexors cavus plantar fascia, intrinsics dorsiflexors varus posterior tibialis and anterior tibialis peroneal brevis supination anterior tibialis peroneus longus flatfoot peroneus brevis posterior tibialis Complex Deformities equinovarus + supination gastroc-soleus complex, posterior tibialis, anterior tibialis peroneus brevis & longus equinovalgus gastroc-soleus complex, peroneals posterior tibialis, anterior tibialis calcaneovalgus foot dorsiflexors/evertors (L4 and L5) plantar flexors /inverters (S1 and S2) Introduction Equinovarus foot most common deformity following stroke use AFO and physical therapy for at least 6 months to await for possible neuro recovery overactivity of the tibialis anterior, with contributions from the FHL, FDL, and tibialis posterior treatment nonoperative AFO fitting physical therapy Phenol or botox injections surgical split anterior tibial tendon transfer (SPLATT) flexor hallucis longus tendon transfer to the dorsum of the foot and release of the flexor digitorum longus and brevis tendons at the base of each toe gastrocnemius or achilles lengthening Physical Exam Silfverskiöld test improved ankle dorsiflexion with knee flexed = gastrocnemius tightness equivalent ankle dorsiflexion with knee flexion and extension= achilles tightness
QUESTIONS 1 of 22 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Previous Next Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK (OBQ04.112) A 54-year-old male with Protein C deficiency sustained a stroke 3 months ago with subsequent left sided weakness. The patient's skin is intact with no sign of ulcerations or callosities. His left foot is developing a varus deformity secondary to a spastic tibialis anterior. His ankle has a 5 degree plantar flexion deformity due to a gastrocnemius contracture which improves with knee flexion (positive Silverskiold test). The patient has an intrinsic minus foot with supple claw toes present. Which of the following is the most appropriate next step in management? Review Topic QID: 1217 1 Gastrocnemius fascia lengthening (Strayer) procedure 16% (249/1591) 2 Split anterior tibial tendon transfer (SPLATT) 15% (231/1591) 3 Flexor hallucis longus tendon transfer to the dorsum of the foot and release of the flexor digitorum longus and brevis tendons at the base of each toe 8% (132/1591) 4 Fractional lengthening of the tibialis posterior 0% (2/1591) 5 Ankle foot orthosis (AFO) with physical therapy 61% (970/1591) ML 2 Select Answer to see Preferred Response PREFERRED RESPONSE 5 (OBQ10.193) Which of the following best describes the physical examination test demonstrated in Figure A? Review Topic QID: 3285 FIGURES: A 1 Silfverskiöld test used to differentiate gastrocnemius tightness from achilles tendon contracture 90% (2436/2696) 2 Thompson test used to differentiate soleus tightness from achilles tendon contracture 0% (11/2696) 3 Coleman test used to differentiate soleus tightness from achilles tendon contracture 1% (25/2696) 4 Silfverskiöld test to differentiate soleus tightness from achilles tendon contracture 7% (185/2696) 5 Thompson test to differentiate gastrocnemius tightness from achilles tendon contracture 1% (29/2696) ML 1 Select Answer to see Preferred Response PREFERRED RESPONSE 1 Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK Sorry, this question is for PEAK Premium Subscribers only Upgrade to PEAK
Upgrade to View Premium Videos Upgrade to View Premium Videos Anatomy Of The Foot & Ankle - Everything You Need To Know - Dr. Nabil Ebraheim Derek Moore General - Foot Muscle Forces & Deformities 8/22/2012 2233 views
Claw Toes and Tarsal Tunnel Syndrome after Type C Weber Fracture (C2351) jose pacheco Foot & Ankle - Foot Muscle Forces & Deformities 9/12/2015 139 2 7