Term
| What are the 3 main etiologies for Rigid Flatfoot? |
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Definition
| "Tarsal Coalition (most common), Fracture, Arthritic Ds." |
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Term
| What is Tarsal Coalition? |
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Definition
| "A bridge between bones of the tarsus. (TC, most common, CN and TN)" |
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Term
| What percent of TC tarsal coalitions are bilateral? |
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Definition
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Term
| What is the most common site of of TC tarsal coalition? |
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Definition
| Middle Facet (then posterior facet) |
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Term
| What percent of CN tarsal coalitions are bilateral? |
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Definition
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Term
| What is a ST pathology that leads to Flatfoot? |
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Definition
| "FF Supinatus, secondary to fully compensated Equinus." |
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Term
| How does Rigid Flatfoot with Tarsal Coalition present? |
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Definition
| "Limited or absent STJ motion on clinical exam (foot 90 degrees to leg, eliminates any AJ motion being mistaken for STJ motion)." |
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Term
| How does Rigid Flatfoot occur with an existing calcaneal fracture? |
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Definition
| Pain with motion of STJ. Pt splints STJ w/ spasm of PB muscle. |
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Term
| When does tarsal coalition become symptomatic? |
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Definition
| During later teenage years (skeletal maturity). |
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Term
| How does Rigid Flatfoot occur w/ a healed fracture? |
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Definition
| "Fracture heals w/in joint causing fusion of joint, secondary to healing. Joint cartilage damaged as a result of the fracture causing pain w/ motion. Pronation of the STJ reduces discomfort between affected joints." |
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Term
| Is the more or less motion in the joints distal to the tarsal coalition? |
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Definition
| More to compensate for the lack of motion at the STJ. |
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Term
| T/F Any arthritic process that damages the articular surface of the joint can result in rigid flatfoot? |
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Definition
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Term
| How does the body relieve pain in STJ from arthritic ds? |
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Definition
| "Pronation. PB goes into spasm, resulting in rigid flatfoot." |
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Term
| "T/F PB spasm is not commonly seen in tarsal coalition, fractures, or arthritic ds?" |
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Definition
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Term
| What are some etiologies of Flexible Flatfoot? |
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Definition
| "Ligamentous, Pre-Hallux (Os Tibiale Externum), Morton’s Foot, Neuromuscular, Ontogenic (compensatory, excessive medial loading)" |
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Term
| "T/F Ligamentous laxity can result in flexible flatfoot, because the ligaments do not perform the role of emergency stabilizers?" |
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Definition
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Term
| What does excess body weight cause at the joints of the foot secondary to pronation of the STJ? |
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Definition
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Term
| What syndrome can present w/ ligamentous laxity? |
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Definition
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Term
| What is the rarity of an Os Tibiale Externum? |
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Definition
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Term
| How does an Os Tibiale Externum cause flexible flatfoot? |
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Definition
| Insertion of the TP muscle (primary supinator) is in the accessory ossicle instead. Altered pull of tendon. Loss of mechanical efficiency. |
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Term
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Definition
| "Short 1st Ray. Results in dorsiflexed 1st Ray, leading to pronation of the STJ to get the 1st Ray to contact the ground." |
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Term
| What does an unsuccessful compensation of Morton’s Foot type lead to ? |
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Definition
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Term
| Any condition that weakens the mechanical advantage of the PB muscle will cause a flexible flatfoot? |
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Definition
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Term
| What nerve is usually damaged to give an advantage to the PB muscle? |
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Definition
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Term
| What are some examples of Ontogenic causes of Flexible Flatfoot? |
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Definition
| "FF Varus, RF Varus, Equinus (flexible planarflexed 1st ray and RF valgus)" |
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Term
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Definition
| Inability of the foot to dorsiflex 10 degrees on the leg w/ the STJ in NEUTRAL positon. |
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Term
| What is one of the primary compensations for Equinus? |
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Definition
| Pronation of the STJ throughout the stance phase of gait. |
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Term
| What does pronation of the STJ cause at the MTJ? |
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Definition
| Pronation (abduction and dorsiflexion at the OMTJ and inversion at the LMTJ) |
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Term
| What are some signs of Flexible Flatfoot? |
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Definition
| "Lateral concavity, Too many toes sign, Everted calcaneus, and STJ pronation." |
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Term
| What is the compensation for FF Varus? |
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Definition
| Pronate the STJ into the propulsive period of the stance phase of gait. |
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Term
| What is the compensation for RF Varus? |
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Definition
| Pronate the sTJ to equalize the GRF across the heel. |
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Term
| What is the average FF Varus deviation? |
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Definition
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Term
| T/F STJ Varus is the same as RF Varus? |
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Definition
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Term
| What Ontogenic condition behaves like a FF Varus? Why? |
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Definition
| Flexible FF Valgus. This is due to the foot being everted in non-weight bearing and then having a dorsiflexed 1st Ray when weight is added. |
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Term
| What is important to note about the calcaneus have over 4 degrees of eversion? |
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Definition
| The STJ will be maximally (abnormally) pronated and will remain pronated throughout stance phase of gait. |
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Term
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Definition
| "NO. Seen with most often w/ Tibial Valgum and Obesity. (the pts fx pronated in gait, not the compensation)" |
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Term
| T/F Anything that places a pronatory moment across the sTJ axis can cause a flexible flatfoot? |
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Definition
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Term
| What is Congenital Convex Pes Valgus? |
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Definition
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Term
| What is the tx for Vertical Talus? |
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Definition
| Serial Casting (younger). Surgical tx requires open reduction w/ fixation (older). |
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Term
| What does abnormally pronated mean in respect to the STJ? |
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Definition
| "Pronation seen at the STJ in the propulsive period. (pronation at OMTJ, supination at LMTJ)" |
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Term
| "T/F If the more proximal joints are unstable, then the more distal joints will forceable be unstable." |
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Definition
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Term
| What will result in greater amounts of frontal plane motion at the STJ? |
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Definition
| Deviation of the STJ so that the axis is more parallel to transverse plane and more perpendicular to the frontal plane. |
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Term
| "Greater frontal plane motion at the STJ, makes it more susceptible to what?" |
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Definition
| Pronatory forces and Flexible Flatfoot. |
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Term
| "T/F Posture can create abnormal STJ pronation, presenting as pain in the knees, hip, legs and back?" |
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Definition
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Term
| Where are the common locations for lesions in a RF Varus? |
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Definition
| "Under 1st, 2nd, and 3rd Met heads (and medial IPJ of the Hallux)" |
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Term
| Where are the common locations for lesions in FF Varus? |
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Definition
| "Hyperkeratosis Sub 2nd Met head (in fully compensated FF varus, can also be sub IPJ of Hallux, or even distal clavus on end of 2nd digit)" |
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Term
| Where are the common locations of lesion seen with Equinus? |
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Definition
| "Diffused callus formation underneath the 2nd, 3rd, and 4th Met heads (also distal clavi on the ends of the distal phalanx of the 2nd, 3rd, and 4th digits.)" |
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Term
| What are the common locations of lesions seen with RF Valgus? |
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Definition
| "Diffused callus formation underneath the 2nd, 3rd, and 4th Met heads. Secondary to hypermobility of the mets during gait." |
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Term
| What are the clinical findings associated with Flatfoot? |
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Definition
| "Aching, Chronic or Long Term, Tired Feet, and Cramping." |
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Term
| What are some alterations in the superstructure due to Flexible Flatfoot? |
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Definition
| "HAV, Contracted digits, HL, Tailor’s Bunion." |
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Term
| What are some clinical findings in the RF? |
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Definition
| "Heel pain, Ankle pain, MF pain." |
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Term
| What is conservative tx for flatfoot? |
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Definition
| Functional Orthotic - Control STJ around the neutral position and FF locked on RF just prior t end of MP (pt must be propulsive). Accommodative Orthotic - Distribute force evenly (will not control abnormal pronation) |
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Term
| Will there be questions on Surgical Procedures? |
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Definition
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