BOOK
Neale's Disorders of the Foot E-Book
Paul Frowen | Maureen O'Donnell | J. Gordon Burrow | Paul Frowen | Maureen O'Donnell | J. Gordon Burrow | Donald L. Lorimer
(2010)
Additional Information
Book Details
Abstract
Neale’s Disorders of the Foot remains the essential resource for students and practitioners of podiatry. All the common conditions encountered in day-to-day podiatric practice are reviewed and their diagnoses and management described along with areas of related therapeutics. Students will find in this one volume everything they need to know about foot disorders and their treatment in order to pass their examinations, while practitioners will continue to appreciate the book’s accessibility and relevance to their daily practice. The new eighth edition is more indispensable than ever before with all contributions revised and brought up to date, colour photographs throughout, an all-new clear and accessible full colour design, and its own website including a full image library, video clips of key techniques and interactive self-assessment questions. Whether you need quick reference or more detailed information, the new and improved Neale’s Disorders of the Foot is ready to serve the needs of a new generation of podiatry students and practitioners.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| half-title | i | ||
| Neale's Disorders of the Foot | iii | ||
| Copyright | iv | ||
| TOC | v | ||
| Web Contents and Evolve information | vii | ||
| Foreword | ix | ||
| Preface to Eighth Edition | xi | ||
| Preface to First Edition | xiii | ||
| Acknowledgements | xv | ||
| Contributors | xvii | ||
| 1 Examination and diagnosis in clinical management | 1 | ||
| CHAPTER CONTENTS | 1 | ||
| KEYWORDS | 1 | ||
| INTRODUCTION | 2 | ||
| GATHERING DATA | 2 | ||
| TAKING A COMPREHENSIVE PODIATRIC HISTORY | 3 | ||
| ELEMENTS OF THE HISTORY | 3 | ||
| Introductory information | 3 | ||
| Chief complaints – soliciting contribution | 4 | ||
| Past medical history | 4 | ||
| Drug/medication history | 4 | ||
| Social history | 4 | ||
| Family history | 4 | ||
| Review of systems | 4 | ||
| ATTRIBUTES OF SYMPTOMS | 4 | ||
| PERFORMING THE PHYSICAL EXAMINATION | 5 | ||
| Mental status | 6 | ||
| Skin (see also Chs 2 and 3) | 6 | ||
| Nails (see also Ch. 3) | 6 | ||
| Swellings | 6 | ||
| Musculoskeletal system (see also Ch. 8) | 6 | ||
| Footwear (see also Ch. 18) | 7 | ||
| Vascular assessment (see also Ch. 12) | 7 | ||
| Neurological assessment (see also Ch. 6) | 9 | ||
| Motor system | 10 | ||
| Inspection | 10 | ||
| Palpation and assessment of tone | 10 | ||
| Assessment of power | 10 | ||
| Assessment of reflexes | 10 | ||
| Assessment of coordination | 11 | ||
| Motor and sensory system functions | 11 | ||
| Sensory investigations | 11 | ||
| Light touch | 11 | ||
| Pin prick | 11 | ||
| Vibration | 11 | ||
| Gait | 13 | ||
| Static evaluation | 13 | ||
| Dynamic evaluation | 13 | ||
| Other soft tissues | 14 | ||
| Biomechanical examination | 14 | ||
| Further investigations | 14 | ||
| Discharge | 14 | ||
| Skin and nail | 14 | ||
| APPLYING CRITICAL THINKING TO THE INFORMATION GATHERED | 15 | ||
| DEVELOPMENT OF THE DIAGNOSIS | 15 | ||
| CREATING THE RECORD | 15 | ||
| REFERENCES | 16 | ||
| 2 The skin and nails in podiatry | 19 | ||
| CHAPTER CONTENTS | 19 | ||
| KEYWORDS | 20 | ||
| AFFECTATIONS OF THE SKIN | 20 | ||
| STRUCTURE AND FUNCTION OF THE SKIN | 20 | ||
| ACUTE INFLAMMATION | 21 | ||
| CHRONIC WOUNDS (ULCERS) | 21 | ||
| Assessment of chronic wounds | 21 | ||
| Pathogenesis of chronic wounds | 22 | ||
| Management of chronic wounds | 22 | ||
| SCARRING | 23 | ||
| BURNS | 23 | ||
| ATROPHY | 23 | ||
| CHILBLAINS AND CHILLING | 23 | ||
| INFECTIONS AND THE SKIN | 24 | ||
| Bacterial infections | 24 | ||
| Systemic bacterial infections | 24 | ||
| Common skin bacteria and resultant conditions | 24 | ||
| Features of cutaneous infections | 25 | ||
| Management of bacterial infection in the skin | 25 | ||
| Viral infections | 25 | ||
| Verrucae/warts | 26 | ||
| Clinical features of verrucae (warts) | 26 | ||
| Single plantar wart (verruca) | 26 | ||
| Mosaic warts | 26 | ||
| Management | 26 | ||
| Topical preparations for wart treatment | 27 | ||
| Electrosurgery | 27 | ||
| Parasitic infestations | 27 | ||
| VITILIGO | 28 | ||
| DISORDERS OF SWEATING | 28 | ||
| FISSURES | 28 | ||
| CORNS AND CALLUS | 28 | ||
| Pathogenesis of corns and callus | 29 | ||
| Management of corns and callus | 29 | ||
| BURSITIS | 30 | ||
| THE SKIN AS AN INDICATOR OF PSYCHOLOGICAL DISTURBANCE | 30 | ||
| THE NAIL IN HEALTH AND DISEASE | 30 | ||
| Embryonic development and nail growth | 31 | ||
| Blood supply and innervation | 31 | ||
| INVOLUTION (PINCER, OMEGA NAIL) | 32 | ||
| Aetiology | 33 | ||
| Treatment | 33 | ||
| ONYCHOCRYPTOSIS (INGROWING TOENAIL) | 33 | ||
| Aetiology | 34 | ||
| Treatment | 34 | ||
| SUBUNGUAL EXOSTOSIS | 35 | ||
| Pathology | 35 | ||
| 3 Dermatological conditions of the foot and leg | 45 | ||
| CHAPTER CONTENTS | 45 | ||
| KEYWORDS | 46 | ||
| Inflammatory skin diseases | 46 | ||
| PSORIASIS AND RELATED DISORDERS | 46 | ||
| Treatment | 47 | ||
| Palmoplantar pustular psoriasis (PPP) | 47 | ||
| REITER’S DISEASE | 47 | ||
| PITYRIASIS RUBRA PILARIS (PRP) | 47 | ||
| ECZEMA (DERMATITIS) AND RELATED DISORDERS | 47 | ||
| Atopic eczema | 48 | ||
| Treatment | 48 | ||
| Contact dermatitis | 48 | ||
| Stasis and varicose eczema | 49 | ||
| Pompholyx | 49 | ||
| Juvenile plantar dermatosis | 49 | ||
| LICHEN PLANUS | 49 | ||
| ICHTHYOSIS | 50 | ||
| KERATODERMAS | 50 | ||
| Inherited palmoplantar keratodermas | 50 | ||
| Aetiology | 50 | ||
| Clinical features | 50 | ||
| Treatment | 50 | ||
| Acquired keratoderma | 51 | ||
| Keratoderma climactericum | 51 | ||
| Acrokeratosis paraneoplastica (Bazex’s syndrome) | 51 | ||
| Keratoderma and hypothyroidism | 52 | ||
| Blistering disorders | 52 | ||
| EPIDERMOLYSIS BULLOSA: THE INHERITED MECHANOBULLOUS DISORDERS | 52 | ||
| AUTOIMMUNE BLISTERING DISORDERS | 53 | ||
| Tumours | 53 | ||
| CAUSES OF SKIN TUMOURS | 54 | ||
| EPIDERMAL TUMOURS | 54 | ||
| Seborrhoeic keratosis | 54 | ||
| Aetiology | 54 | ||
| Clinical features | 54 | ||
| 4 Adult foot disorders | 81 | ||
| CHAPTER CONTENTS | 81 | ||
| KEYWORDS | 82 | ||
| CLINICAL BIOMECHANICS | 82 | ||
| The neutral or reference position | 82 | ||
| The principle of compensation | 83 | ||
| The gait or walking cycle | 83 | ||
| Activity of the muscles and joints of the limb in gait | 83 | ||
| LOWER LIMB AND FOOT ANOMALIES | 84 | ||
| FRONTAL PLANE ANOMALIES OF THE LOWER LIMB AND FOOT | 84 | ||
| Leg-length discrepancy | 84 | ||
| Incidence of LLD | 84 | ||
| Causes of LLD | 84 | ||
| Effects of LLD | 84 | ||
| Symptoms of LLD | 85 | ||
| Significance of the degree of LLD | 85 | ||
| Assessment and measurement of LLD | 85 | ||
| Management of LLD | 85 | ||
| The inverted or varus rearfoot | 85 | ||
| Coxa valgum, genu vara, tibia vara (bowleg) | 85 | ||
| Rearfoot varus | 86 | ||
| Causes of rearfoot varus | 86 | ||
| Classifications of rearfoot varus | 86 | ||
| Compensatory mechanisms in rearfoot varus | 86 | ||
| Other compensatory mechanisms in rearfoot varus | 86 | ||
| Uncompensated rearfoot varus | 86 | ||
| Signs and symptoms of an uncompensated rearfoot varus | 87 | ||
| Fully compensated rearfoot varus | 87 | ||
| Signs and symptoms of fully compensated rearfoot varus | 87 | ||
| Partially compensated rearfoot varus | 87 | ||
| Signs and symptoms of partially compensated rearfoot varus | 87 | ||
| Treatment of rearfoot varus | 87 | ||
| Varus rearfoot | 87 | ||
| The inverted or varus forefoot | 88 | ||
| Forefoot varus | 88 | ||
| Causes of forefoot varus | 88 | ||
| Classifications of forefoot varus | 88 | ||
| Compensatory mechanisms in forefoot varus | 88 | ||
| Fully compensated forefoot varus | 89 | ||
| Signs and symptoms of fully compensated forefoot varus | 89 | ||
| Uncompensated forefoot varus | 89 | ||
| Signs and symptoms of uncompensated forefoot varus | 89 | ||
| Partially compensated forefoot varus | 89 | ||
| Signs and symptoms of partially compensated forefoot varus | 89 | ||
| Treatment of forefoot varus | 89 | ||
| Forefoot supinatus | 89 | ||
| Causes of forefoot supinatus | 89 | ||
| Clinical recognition of forefoot supinatus | 89 | ||
| Treatment of forefoot supinatus | 89 | ||
| The everted or valgus rearfoot | 90 | ||
| Coxa vara and genu valga/valgum (knock knees) | 90 | ||
| True rearfoot valgus | 90 | ||
| The valgus rearfoot | 90 | ||
| The everted or valgus forefoot | 90 | ||
| Forefoot valgus | 90 | ||
| Causes of forefoot valgus | 90 | ||
| Classification of forefoot valgus | 90 | ||
| Rigid-type forefoot valgus | 90 | ||
| Signs and symptoms of rigid forefoot valgus | 91 | ||
| Mobile type forefoot valgus | 91 | ||
| Signs and symptoms of mobile forefoot valgus | 91 | ||
| Treatment of forefoot valgus | 91 | ||
| SAGITTAL PLANE ANOMALIES OF THE LOWER LIMB AND FOOT | 91 | ||
| Pelvic nutation | 91 | ||
| Genu recurvatum | 91 | ||
| Ankle equinus | 92 | ||
| Aetiology and presentations of ankle equinus | 92 | ||
| Classification of ankle equinus | 92 | ||
| Treatment of ankle equinus | 93 | ||
| Plantar flexed first metatarsal | 93 | ||
| Hallux limitus/rigidus | 93 | ||
| Aetiology of hallux limitus | 93 | ||
| Intrinsic factors | 93 | ||
| Extrinsic factors | 93 | ||
| Pathology of hallux limitus | 94 | ||
| Reduction in normal foot function, as the result of first ray anomalies | 94 | ||
| Pathophysiological effects of a reduced range of motion at the first metatarsophalangeal joint | 94 | ||
| Classification of hallux limitus | 95 | ||
| Clinical picture of hallux limitus | 95 | ||
| Gait and posture effects of structural hallux limitus | 95 | ||
| Pain associated with hallux limitus and hallux rigidus | 97 | ||
| Shoe-wear marks | 97 | ||
| Diagnosis and differential diagnoses | 97 | ||
| Treatment of hallux limitus and hallux rigidus | 97 | ||
| Conservative treatments | 97 | ||
| Surgical treatment of hallux limitus and hallux rigidus | 98 | ||
| Hallux flexus (acute hallux limitus) | 98 | ||
| Pathology of hallux flexus | 98 | ||
| Diagnosis of hallux flexus | 98 | ||
| Treatment of hallux flexus | 98 | ||
| Functional hallux limitus | 99 | ||
| Sagittal plane blockade | 99 | ||
| Hypermobile medial column/first ray | 99 | ||
| Metatarsus primus elevatus | 99 | ||
| Plantar-flexed fifth metatarsal | 99 | ||
| ABNORMALITIES OF ARCH HEIGHT | 99 | ||
| Pes planus | 99 | ||
| Classification of pes planus | 99 | ||
| Consequences of pes planus | 100 | ||
| Treatment of pes planus | 100 | ||
| Pes cavus | 100 | ||
| Aetiology of pes cavus | 100 | ||
| Treatment of pes cavus | 100 | ||
| TRANSVERSE PLANE ANOMALIES OF THE LOWER LIMB AND FOOT | 100 | ||
| Hallux abducto valgus | 100 | ||
| Normal anatomy of the first ray | 101 | ||
| Planar movements at the normal first metatarsophalangeal joint | 103 | ||
| Incidence of hallux abducto valgus | 103 | ||
| Aetiology of hallux abducto valgus | 103 | ||
| Factors that predispose to the development of hallux abducto valgus | 103 | ||
| Intrinsic factors | 103 | ||
| Extrinsic factors | 103 | ||
| Variants of normal foot anatomy | 103 | ||
| Metatarsus primus varus | 103 | ||
| Relative length of the first metatarsal | 104 | ||
| Decreased muscular function | 104 | ||
| Iatrogenic or idiopathic features | 104 | ||
| Pathology of hallux abducto valgus | 104 | ||
| Excessive or prolonged foot pronation | 104 | ||
| Pronation and supination in the first ray | 104 | ||
| Change in the orientation of the skeletal and soft tissue components that make up the first ray | 104 | ||
| The influence of the position of the sesamoid complex (Fig 4.13) | 105 | ||
| Dysfunction of soft tissue structures in hallux abducto valgus | 105 | ||
| Clinical picture in hallux abducto valgus | 106 | ||
| Clinical examination in hallux adducto valgus | 106 | ||
| Non-weight-bearing examination | 106 | ||
| Standing examination | 108 | ||
| Diagnosis of hallux abducto valgus | 108 | ||
| Treatment of hallux abducto valgus | 109 | ||
| Conservative and symptomatic management of nail and soft tissue pathologies | 109 | ||
| Orthotic therapy | 109 | ||
| Surgical correction of the forefoot deformity | 109 | ||
| OTHER FOOT DISORDERS | 110 | ||
| Osteochondrosis/osteochondritis | 110 | ||
| Classification | 110 | ||
| Aetiology | 110 | ||
| Diagnosis | 110 | ||
| Differential diagnosis | 110 | ||
| Treatment | 110 | ||
| Freiberg’s disease (Freiberg’s infraction) | 111 | ||
| Pathology | 111 | ||
| Clinical picture | 111 | ||
| Diagnosis and differential diagnosis | 111 | ||
| Treatment | 112 | ||
| Kohler’s disease | 113 | ||
| 5 Circulatory disorders | 145 | ||
| CHAPTER CONTENTS | 145 | ||
| KEYWORDS | 145 | ||
| INTRODUCTION | 146 | ||
| ARTERIOSCLEROSIS (HARDENING OF THE ARTERIES) | 146 | ||
| ATHEROSCLEROSIS (MACROVASCULAR DISEASE) | 146 | ||
| Epidemiology | 146 | ||
| Pathology | 146 | ||
| RISK FACTORS | 147 | ||
| Modifiable factors | 147 | ||
| Smoking | 147 | ||
| Lipid disorders | 147 | ||
| Primary hyperlipidaemias | 147 | ||
| Secondary hyperlipidaemias | 147 | ||
| Diabetes mellitus | 147 | ||
| Hypertension | 147 | ||
| Obesity | 147 | ||
| Homocysteine | 147 | ||
| Haemostatic variables | 148 | ||
| Sedentary lifestyle | 148 | ||
| Dietary deficiencies of antioxidant vitamins and polyunsaturated fatty acids | 148 | ||
| Type A behaviour pattern (TABP) | 148 | ||
| Fixed factors | 148 | ||
| Age and sex | 148 | ||
| Family history | 148 | ||
| CLINICAL FEATURES | 148 | ||
| Intermittent claudication | 148 | ||
| Rest pain | 149 | ||
| DIAGNOSIS | 149 | ||
| ASSESSMENT OF SKIN BLOOD FLOW | 150 | ||
| CLINICAL MANAGEMENT | 151 | ||
| Risk reduction | 151 | ||
| Smoking | 151 | ||
| Elevated cholesterol | 151 | ||
| Glycaemic control | 151 | ||
| Blood pressure control | 151 | ||
| Obesity | 151 | ||
| Antiplatelet therapy | 151 | ||
| Elevated homocysteine | 151 | ||
| Drug therapy | 151 | ||
| Exercise therapy | 151 | ||
| Alternative therapies | 151 | ||
| Vascular intervention | 151 | ||
| ACUTE ARTERIAL OCCLUSION | 152 | ||
| VASCULITIS | 152 | ||
| Thromboangiitis obliterans (Buerger’s disease) | 152 | ||
| Epidemiology | 152 | ||
| Aetiology | 152 | ||
| Clinical features | 152 | ||
| Pathology | 152 | ||
| Differential diagnosis | 152 | ||
| Treatment | 152 | ||
| Prognosis | 152 | ||
| Polyarteritis nodosa | 153 | ||
| 6 Neurological disorders in the lower extremity | 159 | ||
| CHAPTER CONTENTS | 159 | ||
| KEYWORDS | 159 | ||
| THE SPINAL CORD PATHWAYS AND CLINICAL EXAMINATION | 160 | ||
| Ascending pathways | 160 | ||
| Descending pathways | 161 | ||
| PERIPHERAL NERVE INJURY | 161 | ||
| PERIPHERAL ENTRAPMENT NEUROPATHIES | 161 | ||
| HEREDITARY MOTOR AND SENSORY NEUROPATHIES | 165 | ||
| SPINAL RADICULOPATHIES | 166 | ||
| CHARACTERISTICS OF CEREBELLAR LESIONS | 166 | ||
| CHARACTERISTICS OF BASAL GANGLIA LESIONS | 167 | ||
| Hyperkinetic dyskinesias | 167 | ||
| Huntington’s chorea | 167 | ||
| Sydenham’s chorea or St Vitus’ dance | 167 | ||
| Hypokinetic dyskinesias | 168 | ||
| Parkinsonism | 168 | ||
| CEREBRAL PALSY | 168 | ||
| AUTONOMIC NERVOUS SYSTEM | 169 | ||
| Sympathetic nervous system dysfunction in the lower extremity | 169 | ||
| DIABETIC PERIPHERAL NEUROPATHY | 170 | ||
| CHARCOT JOINT DISEASE | 171 | ||
| DISORDERS OF NEUROMUSCULAR TRANSMISSION | 173 | ||
| REFERENCES | 174 | ||
| FURTHER READING | 174 | ||
| Peripheral nerve injury | 174 | ||
| Low back pain | 174 | ||
| Hereditary motor and sensory neuropathies | 174 | ||
| Entrapment neuropathies | 174 | ||
| Cerebellar lesions | 175 | ||
| Basal ganglion disease | 175 | ||
| Cerebral palsy | 175 | ||
| Diabetic neuropathy | 175 | ||
| Complex regional pain syndrome | 175 | ||
| Myasathenic syndromes | 175 | ||
| 7 Podiatry in the management of leprosy and tropical diseases | 177 | ||
| CHAPTER CONTENTS | 177 | ||
| KEYWORDS | 177 | ||
| INTRODUCTION | 177 | ||
| LEPROSY | 177 | ||
| Epidemiology | 178 | ||
| Classification | 178 | ||
| Neuropathy in tuberculoid leprosy | 178 | ||
| Neuropathy in lepromatous leprosy | 178 | ||
| Neuropathy in borderline (dimorphous) leprosy | 179 | ||
| The lower limb in Hansen’s disease | 179 | ||
| Anaesthesia | 179 | ||
| Factors associated with plantar ulceration | 179 | ||
| Motor paralysis | 179 | ||
| Claw toes | 179 | ||
| Extrinsic muscle paralysis | 179 | ||
| Pre-existing pathomechanical foot function | 179 | ||
| Tarsal disintegration | 179 | ||
| Absorption and pathological fractures | 180 | ||
| Autonomic impairment | 180 | ||
| Social and behavioural variables | 180 | ||
| Complications of ulceration | 180 | ||
| Secondary infection | 180 | ||
| Squamous-cell carcinoma | 180 | ||
| Treatment of pedal pathologies | 181 | ||
| Ulceration | 181 | ||
| The active phase of ulceration | 181 | ||
| The proliferative phase of ulceration | 181 | ||
| The maturation or remodelling phase of ulceration | 182 | ||
| Mal perforans | 182 | ||
| Enhancing the healing process | 182 | ||
| Infection control | 182 | ||
| Maintaining an optimal wound environment | 182 | ||
| Rest | 182 | ||
| Orthotic options | 183 | ||
| Case studies | 183 | ||
| TROPICAL DISEASES | 184 | ||
| Bacterial infections | 185 | ||
| Pyogenic infections | 185 | ||
| Aetiology and pathogenesis | 185 | ||
| Clinical findings and diagnosis | 185 | ||
| Management and treatment | 185 | ||
| Treponemal infections | 186 | ||
| Other bacterial infections manifesting on the foot | 186 | ||
| Mycobacterial infections | 186 | ||
| Aetiology and pathogenesis | 186 | ||
| Clinical findings and diagnosis | 186 | ||
| Fish-tank granuloma | 186 | ||
| Leprosy | 187 | ||
| Skin tuberculosis | 187 | ||
| Buruli ulcer | 187 | ||
| Management and treatment of mycobacterial infections | 187 | ||
| Bacterial mycetoma | 187 | ||
| Aetiology and pathogenesis | 187 | ||
| 8 Musculoskeletal disorders | 199 | ||
| CHAPTER CONTENTS | 199 | ||
| KEYWORDS | 199 | ||
| INTRODUCTION | 199 | ||
| DEFINING RHEUMATOLOGY AND THE MUSCULOSKELETAL DISEASES | 200 | ||
| GENERAL EPIDEMIOLOGY OF RHEUMATIC CONDITIONS | 200 | ||
| BURDEN OF DISEASE | 200 | ||
| THE EPIDEMIOLOGY OF FOOT PROBLEMS GENERALLY AND IN RHEUMATOLOGY | 200 | ||
| A BRIEF OVERVIEW OF DEVELOPMENTS IN MEDICAL RHEUMATOLOGY | 200 | ||
| MEDICAL MANAGEMENT IN RHEUMATOLOGY – OVERVIEW ACROSS DISEASES | 201 | ||
| THE FOOT IN RHEUMATOLOGY – OVERVIEW ACROSS DISEASES | 203 | ||
| Assessing the foot | 203 | ||
| Management principles | 204 | ||
| Provision of foot health services – current provision, multidisciplinary involvement, surgery | 204 | ||
| Service provision | 205 | ||
| Education and self-management advice | 205 | ||
| General foot care, nail cutting, corn and callus reduction, provision of padding | 205 | ||
| High-risk management of the vasculitic or ulcerative foot | 205 | ||
| Extended scope practice and surgery | 205 | ||
| SPECIFIC DISEASES | 206 | ||
| Seropositive inflammatory arthritis | 206 | ||
| Rheumatoid arthritis | 206 | ||
| Definition | 206 | ||
| Epidemiology | 206 | ||
| Diagnosis | 206 | ||
| Pathology | 206 | ||
| Clinical course | 206 | ||
| Medical management | 207 | ||
| The foot in rheumatoid arthritis | 207 | ||
| Hindfoot | 207 | ||
| Midfoot | 208 | ||
| Forefoot | 208 | ||
| Subcutaneous lesions | 210 | ||
| Skin and nails | 210 | ||
| Vasculitis | 210 | ||
| Juvenile idiopathic arthritis | 211 | ||
| Definition | 211 | ||
| Epidemiology | 211 | ||
| Classification | 211 | ||
| Diagnosis | 211 | ||
| Pathology | 211 | ||
| Clinical course | 211 | ||
| Medical management | 211 | ||
| The foot in juvenile idiopathic arthritis | 211 | ||
| Polyarticular type | 211 | ||
| Enthesitis-related arthritis and psoriatic arthritis | 212 | ||
| Seronegative inflammatory arthritis: | 212 | ||
| Introduction – common features | 212 | ||
| Ankylosing spondylitis (inflammatory back pain) | 212 | ||
| Definition | 212 | ||
| Epidemiology | 212 | ||
| Diagnosis | 212 | ||
| Pathology | 212 | ||
| 9 Metabolic disorders | 231 | ||
| CHAPTER CONTENTS | 231 | ||
| KEYWORDS | 231 | ||
| DIABETES MELLITUS | 231 | ||
| Type 1 diabetes | 232 | ||
| Type 2 diabetes | 232 | ||
| Secondary diabetes | 232 | ||
| Diagnosis | 232 | ||
| Clinical features | 232 | ||
| Treatment | 232 | ||
| Treatment of type 1 diabetes mellitus | 232 | ||
| Treatment of type 2 diabetes mellitus | 233 | ||
| Hypoglycaemia | 233 | ||
| Complications and control of diabetes | 233 | ||
| Eye disease | 233 | ||
| Background retinopathy | 234 | ||
| Proliferative retinopathy | 234 | ||
| Kidney disease | 234 | ||
| Neuropathy | 234 | ||
| Symmetrical sensory and autonomic neuropathy | 234 | ||
| Neuropathies that recover, mononeuropathies, radiculopathies and acute painful neuropathies | 235 | ||
| Pressure palsies | 235 | ||
| Symptomatic autonomic neuropathy | 235 | ||
| Symptoms | 235 | ||
| Diagnosis | 235 | ||
| Vascular disease | 235 | ||
| The diabetic foot | 235 | ||
| The neuropathic foot | 236 | ||
| Neuropathic ulcer | 236 | ||
| Complications of ulceration | 236 | ||
| Management of ulceration | 236 | ||
| Neuropathic (Charcot) joint | 237 | ||
| 10 Management of high-risk patients | 243 | ||
| CHAPTER CONTENTS | 243 | ||
| KEYWORDS | 243 | ||
| AIMS IN MANAGING HIGH-RISK PATIENTS | 244 | ||
| PREVENTION OF COMPLICATIONS | 244 | ||
| History taking and assessment | 244 | ||
| General points regarding treatment | 245 | ||
| MANAGEMENT OF ESTABLISHED WOUNDS, INFECTION OR NECROSIS | 245 | ||
| Examination of the wound | 245 | ||
| Infection | 246 | ||
| Management of wounds | 247 | ||
| Desloughing and wound cleansing agents | 247 | ||
| Desloughing agents | 247 | ||
| Wound-cleansing agents and antiseptics | 248 | ||
| Antiseptics | 248 | ||
| Dressings | 248 | ||
| 1. The ability to remove exudate | 248 | ||
| 2. The ability to maintain humidity at the wound–dressing interface | 248 | ||
| 3. Permeability of the dressing to gases | 249 | ||
| 4. The ability to be impermeable to microorganisms | 249 | ||
| 5. The ability to maintain a suitable temperature at the wound surface | 249 | ||
| 6. The ability to maintain low adherence at the wound–dressing interface | 249 | ||
| 7. The ability to be free from contaminants | 249 | ||
| 8. The ability to maintain a suitable pH | 249 | ||
| 9. Other factors, including patient acceptability, ease of application and comfort, and cost | 249 | ||
| Types of dressing for use in podiatric practice | 249 | ||
| Conventional dressings | 249 | ||
| Primary wound-dressing films | 249 | ||
| Semipermeable adhesive film dressings | 249 | ||
| Perforated film absorbent dressings | 249 | ||
| Low-adherent wound contact layers | 250 | ||
| Unmedicated | 250 | ||
| Medicated | 250 | ||
| Semipermeable hydrogels | 250 | ||
| Hydrocolloids | 250 | ||
| Alginate dressings | 250 | ||
| Polyurethane foams | 250 | ||
| Silver agents | 250 | ||
| Other dressings – the way forward? | 250 | ||
| OTHER ASPECTS OF MANAGEMENT | 251 | ||
| CONCLUSIONS | 251 | ||
| REFERENCES | 252 | ||
| FURTHER READING | 252 | ||
| 11 Podiatric management of the elderly | 253 | ||
| CHAPTER CONTENTS | 253 | ||
| KEYWORDS | 253 | ||
| INTRODUCTION | 253 | ||
| NAIL CONDITIONS AND CARE | 254 | ||
| RISK FACTORS ASSOCIATED WITH THE DEVELOPMENT OF ULCERATION IN THE FEET AND LEGS | 256 | ||
| Health professionals involved in multidisciplinary care | 256 | ||
| Dietician | 256 | ||
| District nurse | 257 | ||
| Vascular specialist | 257 | ||
| MUSCULOSKELETAL CHANGES | 257 | ||
| Muscle tissue | 257 | ||
| Tendon and ligament | 258 | ||
| Management of change | 258 | ||
| FALLS IN OLDER PEOPLE | 259 | ||
| Risk factors associated with falls | 259 | ||
| What is the ideal footwear style for an older person? | 260 | ||
| POLYPHARMACY | 261 | ||
| Long-term disease and older people | 261 | ||
| QUALITY OF LIFE | 261 | ||
| DUTY OF CARE | 262 | ||
| Hypothermia risk | 263 | ||
| Dehydration | 264 | ||
| Dementia and depression | 264 | ||
| Osteoporosis and fracture | 265 | ||
| Incontinence | 265 | ||
| Malnutrition | 266 | ||
| CONCLUSION | 266 | ||
| ACKNOWLEDGEMENT | 266 | ||
| REFERENCES | 266 | ||
| FURTHER READING | 268 | ||
| 12 Paediatric podiatry and genetics | 269 | ||
| CHAPTER CONTENTS | 269 | ||
| KEYWORDS | 270 | ||
| NORMAL GROWTH AND DEVELOPMENT | 271 | ||
| Knock-knee, bow leg and rickets | 272 | ||
| Rickets | 272 | ||
| Flat foot | 273 | ||
| Peak rates of growth | 273 | ||
| FOOTWEAR | 273 | ||
| Inadequate footwear | 274 | ||
| Plimsolls | 274 | ||
| Babywalkers | 275 | ||
| Fashion, peer-group pressure and economics | 275 | ||
| Trainers | 275 | ||
| FOOT TYPE | 275 | ||
| Low-arched and high-arched feet | 276 | ||
| INFECTIONS | 276 | ||
| Onychocryptosis (ingrowing toenail) | 276 | ||
| ANATOMICAL ANOMALIES | 277 | ||
| Sesamoid bones | 277 | ||
| Supernumerary bones | 277 | ||
| Tarsal coalition (peroneal spastic flat foot) | 277 | ||
| BIOMECHANICAL ANOMALIES/ABNORMALITIES | 277 | ||
| Acquired deformity | 277 | ||
| Mucopolysaccharidosis | 277 | ||
| Juvenile hallux abducto valgus | 277 | ||
| INJURIES | 278 | ||
| Juvenile hallux rigidus | 278 | ||
| CONGENITAL ABNORMALITIES | 278 | ||
| BASIC PRINCIPLES OF HUMAN GENETICS | 278 | ||
| GENETIC AND CONGENITAL DISORDERS | 278 | ||
| Chromosome abnormalities | 279 | ||
| Single-gene disorders | 279 | ||
| Multifactorial disorders | 279 | ||
| SYNDROMES | 279 | ||
| The lower limbs | 279 | ||
| Polydactyly | 279 | ||
| Syndactyly (webbed toes – zygodactyly) | 279 | ||
| ASSESSMENT OF A FAMILY WITH A GENETIC DISORDER | 280 | ||
| Drawing the family tree | 280 | ||
| Interpreting the family tree | 280 | ||
| OLIGODACTYLY | 281 | ||
| CONGENITAL OVERLAPPING FIFTH TOE (DIGITI MINIMI QUINTI VARUS) | 281 | ||
| CURLY TOES | 281 | ||
| CONGENITAL FLEXED TOE | 281 | ||
| METATARSUS ADDUCTUS | 281 | ||
| HALLUX VARUS | 282 | ||
| CONGENITAL TALIPES EQUINOVARUS: CLUBFOOT | 282 | ||
| TALIPES CALCANEOVALGUS | 283 | ||
| VERTICAL TALUS (ROCKER BOTTOM FOOT) | 283 | ||
| ONYCHOGRYPHOSIS | 283 | ||
| ARTHROGRYPOSIS MULTIPLEX CONGENITA | 283 | ||
| CONGENITAL CONSTRICTION BAND SYNDROME | 283 | ||
| POSTURAL ANOMALIES/ABNORMALITIES | 283 | ||
| SURGICAL/MEDICAL CONDITIONS | 283 | ||
| Leg-length discrepancy | 283 | ||
| Linear scleroderma | 284 | ||
| Localised scleroderma (morphea) | 284 | ||
| Pes cavus | 284 | ||
| Sever’s disease (calcaneal apophysitis) | 285 | ||
| Kohler’s disease of the navicular | 285 | ||
| Freiberg’s disease | 285 | ||
| Stress fracture of a metatarsal (march or fatigue fracture) | 285 | ||
| Diabetes | 285 | ||
| Poliomyelitis | 285 | ||
| Spina bifida cystica | 286 | ||
| Cerebral palsy | 286 | ||
| Muscular dystrophies | 286 | ||
| Duchenne muscular dystrophy | 287 | ||
| Hypermobility syndrome | 287 | ||
| Ehlers–Danlos syndrome | 288 | ||
| Limb pain of childhood with no organic disease | 288 | ||
| Juvenile idiopathic arthritis (juvenile chronic arthritis) | 288 | ||
| Psoriatic arthritis | 288 | ||
| Raynaud’s phenomenon | 289 | ||
| Haemophilia | 289 | ||
| Turner’s syndrome | 290 | ||
| Down’s syndrome (trisomy 21) | 290 | ||
| Tuberous sclerosis | 291 | ||
| DERMATOLOGICAL CONDITIONS | 291 | ||
| EXAMINATION AND ASSESSMENT | 291 | ||
| Observe gait and posture with footwear | 292 | ||
| Subjective questioning of child and/or parent | 292 | ||
| Measure feet, measure footwear | 292 | ||
| Examine footwear | 292 | ||
| Visual examination of foot for skin, nail, soft-tissue and bony lesions | 292 | ||
| Physical examination of lesions as required | 293 | ||
| Physical examination of range, quality and direction of motion in all joints of the foot | 293 | ||
| Biomechanical assessment, including examination for forefoot/rearfoot malalignment | 293 | ||
| Observe and assess barefooted gait and general posture | 293 | ||
| Comparison | 293 | ||
| Diagnosis | 293 | ||
| Produce a management plan | 293 | ||
| Written information | 294 | ||
| MANAGEMENT | 294 | ||
| Footwear advice and prescription | 294 | ||
| Passive and active exercises | 295 | ||
| Orthoses for passive and dynamic use | 295 | ||
| Night splints | 295 | ||
| Silicone | 296 | ||
| Casted foot orthoses | 296 | ||
| THE ROLE OF THE PAEDIATRIC PODIATRIST | 296 | ||
| REFERENCES | 296 | ||
| FURTHER READING | 296 | ||
| 13 Sports medicine and injuries | 297 | ||
| CHAPTER CONTENTS | 297 | ||
| KEYWORDS | 298 | ||
| INTRODUCTION | 298 | ||
| ATHLETIC PROFILE AND HISTORY TAKING | 298 | ||
| Past treatment history | 299 | ||
| CHRONIC OR OVERUSE INJURIES | 300 | ||
| Physical factors | 300 | ||
| Psychological factors | 301 | ||
| Patient constraints | 301 | ||
| RUNNING | 303 | ||
| The four phases of running | 303 | ||
| The walking–running cycle | 303 | ||
| Marathon running | 305 | ||
| CHILD AND ADOLESCENT SPORTS | 306 | ||
| FOOTBALL – SOCCER | 308 | ||
| GYMNASTICS | 309 | ||
| BASKETBALL | 309 | ||
| BOWLING | 310 | ||
| TENNIS | 310 | ||
| GOLF | 311 | ||
| AMERICAN FOOTBALL | 311 | ||
| RUGBY | 312 | ||
| STEP/BENCH AEROBICS | 312 | ||
| BALLET AND DANCE | 313 | ||
| Tendinitis | 314 | ||
| Posterior and anterior impingement syndrome of the ankle | 314 | ||
| Shin splints | 314 | ||
| Ankle sprains and toe sprains | 315 | ||
| Stress fractures | 315 | ||
| Hallux limitus | 315 | ||
| Bunion deformities | 315 | ||
| Neuromas | 315 | ||
| Nail problems | 315 | ||
| BASEBALL | 315 | ||
| SKIING | 316 | ||
| Cross-country skiing | 317 | ||
| SNOWBOARDING | 317 | ||
| FOREFOOT INJURIES | 317 | ||
| Metatarsalgia | 318 | ||
| Capsulitis | 318 | ||
| Bursa formation and bursitis | 318 | ||
| Sesamoiditis and fracture | 318 | ||
| Metatarsal stress fractures | 319 | ||
| Osteochondritis dissicans – Freiberg’s infraction | 321 | ||
| Morton’s neuroma | 322 | ||
| Hallux limitus and rigidus | 324 | ||
| Bunion deformity in the athlete | 326 | ||
| Tailor’s bunion | 327 | ||
| REARFOOT INJURIES | 328 | ||
| Infracalcaneal heel pain | 328 | ||
| Ankle equinus | 331 | ||
| Achilles tendon injuries | 331 | ||
| Partial rupture of the Achilles tendon | 334 | ||
| Acute complete rupture of the Achilles tendon | 334 | ||
| Insertional Achilles tendinitis and calcific tendinosis | 336 | ||
| Retrocalcaneal exostosis (Haglund’s deformity) | 338 | ||
| ANKLE INJURIES | 339 | ||
| Anatomy | 340 | ||
| LEG INJURIES | 344 | ||
| Chronic leg pain in the athlete | 344 | ||
| Tibial fasciitis – shin splints | 344 | ||
| Treatment | 345 | ||
| Stress fracture of the tibia and fibula | 345 | ||
| Acute and chronic compartment syndrome | 347 | ||
| Anatomy | 348 | ||
| Muscle soreness | 349 | ||
| Muscle cramps | 349 | ||
| Muscle herniations | 349 | ||
| Posterior tibial tendon dysfunction in the athlete | 349 | ||
| Anatomy | 349 | ||
| Aetiology | 350 | ||
| History, physical examination and clinical findings | 350 | ||
| Fibular (peroneal) tendinitis and tenosynovitis | 353 | ||
| Subluxing fibularis (peroneus) tendons | 353 | ||
| Overuse knee injuries | 354 | ||
| Definition | 354 | ||
| Symptoms | 354 | ||
| Signs | 354 | ||
| Treatment | 355 | ||
| Biomechanical causes of knee injuries | 355 | ||
| The patellofemoral joint | 355 | ||
| Patellofemoral problems in runners | 356 | ||
| Chondromalacia patellae | 356 | ||
| Knee plica | 357 | ||
| Iliotibial band friction syndrome | 357 | ||
| Popliteus tendinitis | 358 | ||
| Hamstring tendinitis | 359 | ||
| Groin injury/strain | 359 | ||
| LEG-LENGTH DISCREPANCY | 360 | ||
| THE FEMALE ATHLETE TRIAD | 360 | ||
| SPORTS SHOES | 361 | ||
| Shoe manufacture | 361 | ||
| Lasts | 361 | ||
| Shape of the last | 361 | ||
| Other factors | 362 | ||
| The heel counter | 362 | ||
| The tongue | 362 | ||
| Insole | 362 | ||
| Outsole | 362 | ||
| Midsole | 362 | ||
| Upper | 362 | ||
| Scientific evaluation | 362 | ||
| Features of a good sports shoe | 362 | ||
| REFERENCES | 363 | ||
| 14 Basic biomechanics of gait | 371 | ||
| CHAPTER CONTENTS | 371 | ||
| KEYWORDS | 371 | ||
| INTRODUCTION | 371 | ||
| CONTACT FORCES AND ATTRACTION FORCES | 372 | ||
| Mass and weight | 372 | ||
| Units of force | 372 | ||
| Scalars and vectors | 373 | ||
| CENTRE OF GRAVITY | 373 | ||
| MUSCULOSKELETAL SYSTEM FUNCTION | 373 | ||
| STABILITY | 374 | ||
| CENTRE OF PRESSURE | 374 | ||
| LOAD, STRAIN, AND STRESS | 375 | ||
| Tension stress | 375 | ||
| Compression stress | 376 | ||
| Shear stress | 376 | ||
| GAIT CYCLE | 376 | ||
| Trajectory of the centre of gravity | 376 | ||
| Ground reaction force | 376 | ||
| Components of the ground reaction force | 377 | ||
| Path of the centre of pressure | 378 | ||
| GAIT ANALYSIS | 378 | ||
| Diagnosis of gait disorders | 378 | ||
| Qualitative gait analysis | 379 | ||
| Quantitative gait analysis | 380 | ||
| REFERENCES | 385 | ||
| 15 Structure and function of the foot | 387 | ||
| CHAPTER CONTENTS | 387 | ||
| KEYWORDS | 387 | ||
| INTRODUCTION | 387 | ||
| SKELETON OF THE FOOT | 387 | ||
| MOVEMENTS OF THE ANKLE AND FOOT | 388 | ||
| Ankle joint | 388 | ||
| Subtalar joint | 389 | ||
| Pronation and supination | 389 | ||
| ARCHES OF THE FEET | 390 | ||
| Passive arch support | 390 | ||
| Active arch support | 392 | ||
| Interaction of the arch support mechanisms | 392 | ||
| THE WINDLASS MECHANISM OF THE FOOT | 392 | ||
| STRUCTURAL ADAPTATION OF THE MUSCULOSKELETAL SYSTEM | 393 | ||
| Structural adaptation in bone | 394 | ||
| The chondral modelling phenomenon | 394 | ||
| Modelling of metaphyses and epiphyses | 394 | ||
| Modelling of articular surfaces | 394 | ||
| REFERENCES | 395 | ||
| 16 Clinical therapeutics | 397 | ||
| CHAPTER CONTENTS | 397 | ||
| KEYWORDS | 398 | ||
| THE THERAPEUTIC MANAGEMENT OF SUPERFICIAL LESIONS | 398 | ||
| Operating | 398 | ||
| Medicaments | 398 | ||
| Dressings | 399 | ||
| Padding and strapping | 399 | ||
| Review periods | 399 | ||
| Case records | 399 | ||
| CONTROL AND TREATMENT OF THE HYPERKERATOSES | 400 | ||
| Pathological callus | 400 | ||
| Postoperative antisepsis | 400 | ||
| Emollients | 400 | ||
| Astringents | 400 | ||
| Silicone implants | 400 | ||
| Heloma durum (hard corn) of the digits | 401 | ||
| Heloma durum (hard corns) on the plantar metatarsal area | 401 | ||
| Interdigital heloma | 402 | ||
| Vascular and neurovascular heloma | 402 | ||
| Heloma miliare (seed corns) | 402 | ||
| Palmoplantar hyperkeratosis | 402 | ||
| SHORT-TERM PADDING THERAPY | 402 | ||
| Digital padding for the lesser toes | 402 | ||
| Plantar metatarsal padding | 404 | ||
| THE TREATMENT OF VERRUCA PEDIS | 405 | ||
| The treatment of verrucae | 406 | ||
| Chemical cautery | 406 | ||
| Disadvantages of treatment with chemical therapy | 407 | ||
| Therapeutic agents for chemical cautery | 407 | ||
| Salicylic acid | 407 | ||
| Monochloroacetic acid | 408 | ||
| Trichloroacetic acid | 408 | ||
| Potassium hydroxide | 408 | ||
| Single-treatment techniques | 409 | ||
| Cryotherapy | 409 | ||
| Electrosurgery and radiosurgery using cutting, coagulation, desiccation and fulguration | 410 | ||
| Background | 410 | ||
| Electrosurgical physics | 411 | ||
| Equipment | 411 | ||
| Safety | 412 | ||
| Patient selection | 412 | ||
| Procedures | 412 | ||
| Electrosurgical treatment of verrucae | 413 | ||
| Nail bed ablation | 413 | ||
| Suggested procedure for desiccation of heloma durum (hard corn) | 413 | ||
| INFLAMMATORY CONDITIONS | 414 | ||
| Perniosis (erythema pernio, chilblains) | 414 | ||
| Ulceration | 415 | ||
| TREATMENT OF DISORDERS OF THE SWEAT GLANDS | 415 | ||
| Hyperhidrosis | 415 | ||
| Anhidrosis | 416 | ||
| TREATMENT OF FUNGAL INFECTIONS | 416 | ||
| Tinea pedis | 416 | ||
| Clinical features of tinea pedis | 417 | ||
| Treatment | 417 | ||
| Undecenoic acid | 417 | ||
| Tolnaftate | 417 | ||
| The imidazoles | 418 | ||
| Tea tree oil | 418 | ||
| Tinea unguium (onychomycosis) | 418 | ||
| Clinical features of tinea unguium | 418 | ||
| Candidosis | 419 | ||
| PHYSICAL THERAPY | 419 | ||
| Heat and cold | 419 | ||
| Heat | 419 | ||
| Physiological effects | 419 | ||
| Increased blood supply | 420 | ||
| Generalised effects of heating | 420 | ||
| Heat therapy | 420 | ||
| Infrared radiation | 420 | ||
| Ultrasound | 421 | ||
| Cold | 422 | ||
| Cryotherapy/cold therapy | 422 | ||
| Ice packs | 422 | ||
| Cold sprays | 422 | ||
| FOOTBATHS | 422 | ||
| Methods of application | 423 | ||
| Cold footbaths | 423 | ||
| Contrast footbaths | 423 | ||
| Warm water footbaths | 423 | ||
| Hypertonic footbaths | 423 | ||
| Antiseptic astringent footbaths | 423 | ||
| LASERS | 423 | ||
| Properties of laser light | 423 | ||
| The effect of laser light | 424 | ||
| Safety | 424 | ||
| Treatment technique | 424 | ||
| Contraindications | 424 | ||
| Laser in patient management | 424 | ||
| MAGNETOPULSE | 425 | ||
| Contraindications | 425 | ||
| Operation of magnetopulse equipment | 425 | ||
| Method: machine with two pads | 426 | ||
| Method: machine with four pads | 426 | ||
| Indications | 426 | ||
| NON-THERMAL ELECTROTHERAPY | 426 | ||
| Faradism – muscle stimulation | 426 | ||
| Technique | 426 | ||
| Electrodes | 426 | ||
| Interferential | 427 | ||
| Relief of pain | 427 | ||
| Motor stimulation | 427 | ||
| Technique | 427 | ||
| Contraindications | 427 | ||
| ACUTE AND CHRONIC INFLAMMATORY CONDITIONS | 427 | ||
| Tension strappings | 427 | ||
| Medial support | 428 | ||
| Lateral support | 428 | ||
| Neutral support | 428 | ||
| Valgus padding | 428 | ||
| 17 Orthoses | 435 | ||
| CHAPTER CONTENTS | 435 | ||
| KEYWORDS | 435 | ||
| PRINCIPLES OF MANAGEMENT | 437 | ||
| REPLACEABLE PADS | 437 | ||
| ELASTIC ANKLETS AND BRACELETS | 438 | ||
| INSOLES | 439 | ||
| Non-casted insoles | 439 | ||
| Casted insoles | 439 | ||
| FUNCTIONAL ORTHOSES | 440 | ||
| The Root paradigm | 440 | ||
| The sagittal plane paradigm | 441 | ||
| The proprioceptive, preferred- motion-pathway paradigm | 442 | ||
| The tissue-stress paradigm | 442 | ||
| Paradigms in practice: reconciling the controversy of foot function paradigms | 442 | ||
| Material choice and casting techniques | 443 | ||
| Custom versus prefabricated orthoses | 444 | ||
| CAD–CAM orthoses | 444 | ||
| Prescription writing for CAD-CAM direct-milled orthoses | 444 | ||
| Types of orthosis | 445 | ||
| Prescription variations | 445 | ||
| Flexibility | 445 | ||
| Heel-cup height | 445 | ||
| Width | 445 | ||
| Postings | 445 | ||
| Accommodations | 446 | ||
| Problem solving | 446 | ||
| Devices do not fit shoes | 446 | ||
| Devices cut into the lateral side of the heel | 446 | ||
| First metatarsal irritation | 446 | ||
| Devices are too tight at the heel | 446 | ||
| Irritation in the area of the medial longitudinal arch | 446 | ||
| Insufficient control | 446 | ||
| EEC DIRECTIVE ON THE MANUFACTURE OF ORTHOSES | 446 | ||
| SILIPOS | 446 | ||
| HEEL ORTHOSES | 447 | ||
| LATEX TECHNIQUE | 447 | ||
| DIGITAL APPLIANCES FOR THE LESSER TOES | 447 | ||
| SILICONES | 448 | ||
| THERMOPLASTICS | 448 | ||
| Hot-water plastics (Polyform, Aquaplast Hexcelite, X-Lite Plus) | 450 | ||
| Low-temperature moulding | 450 | ||
| Chairside technique | 450 | ||
| Rapid remoulding | 450 | ||
| No waste | 450 | ||
| Complex construction | 450 | ||
| Hexcelite (X-Lite Plus) | 450 | ||
| CONCLUSION | 451 | ||
| REFERENCES | 451 | ||
| 18 Footwear | 453 | ||
| CHAPTER CONTENTS | 453 | ||
| KEYWORDS | 454 | ||
| INTRODUCTION | 454 | ||
| FUNCTION OF FOOTWEAR | 455 | ||
| Primary function | 455 | ||
| Secondary functions | 455 | ||
| Completing a fashion | 455 | ||
| Conducting specific tasks | 455 | ||
| Compensating for an abnormality | 455 | ||
| PARTS OF A SHOE | 455 | ||
| The upper | 456 | ||
| The toe box | 456 | ||
| The toe cap | 456 | ||
| The vamp | 456 | ||
| The tongue | 456 | ||
| The quarters | 457 | ||
| The sole | 457 | ||
| The insole | 457 | ||
| Bottom fillings | 457 | ||
| The welt | 457 | ||
| The outsole | 457 | ||
| The subsidiary parts | 457 | ||
| The heel | 457 | ||
| The shank | 458 | ||
| The counter | 458 | ||
| The backstay | 458 | ||
| FEATURES OF A GOOD-FITTING SHOE | 458 | ||
| Good retaining medium | 458 | ||
| Close-fitting medial and lateral quarters | 459 | ||
| Adequate width and depth in the toe box | 460 | ||
| Correct length | 460 | ||
| Correct width fitting | 461 | ||
| Adequate heel seat | 461 | ||
| Heel height no greater than 2 inches (5 cm) | 461 | ||
| Broad heel base in contact with the ground | 462 | ||
| Upper material made of leather or other natural material | 462 | ||
| FOOTWEAR AND LAST TERMINOLOGY | 462 | ||
| Tread line | 462 | ||
| Toe spring | 462 | ||
| Rigidity of the outsole | 463 | ||
| Style of shoe | 463 | ||
| Heel height | 463 | ||
| Heel pitch | 463 | ||
| Flare | 463 | ||
| DESIRABLE FEATURES OF FOOTWEAR FOR SPECIFIC FOOT CONDITIONS | 464 | ||
| Hallux abducto valgus | 464 | ||
| Hallux limitus/rigidus | 464 | ||
| The short, broad foot | 464 | ||
| The long, mobile foot | 464 | ||
| The highly arched foot | 464 | ||
| The foot of the patient with rheumatoid arthritis | 464 | ||
| The foot of the patient with diabetes | 464 | ||
| SIZE SYSTEMS AND SYSTEMS OF MEASUREMENT | 465 | ||
| The English size system | 465 | ||
| The Continental size system | 465 | ||
| COMMON FOOTWEAR STYLES | 465 | ||
| Tie lace | 465 | ||
| The Oxford shoe | 465 | ||
| The Derby shoe | 466 | ||
| The moccasin-style shoe | 466 | ||
| The sandal | 466 | ||
| The court shoe | 466 | ||
| Sports shoes | 467 | ||
| Boots | 467 | ||
| WEAR MARKS AS AN AID TO DIAGNOSIS | 467 | ||
| Normal wear | 467 | ||
| The outsole and heel | 467 | ||
| The insole (sock lining) | 467 | ||
| The lining of the upper | 467 | ||
| 19 Pain control | 479 | ||
| CHAPTER CONTENTS | 479 | ||
| KEYWORDS | 479 | ||
| DEFINITION | 479 | ||
| ANATOMY | 480 | ||
| SOMATIC PAIN | 480 | ||
| PHYSIOLOGY | 481 | ||
| Peripheral nociceptor level | 481 | ||
| Spinal level | 481 | ||
| Supraspinal level | 482 | ||
| Neuropathic pain | 482 | ||
| PRINCIPLES OF PAIN MANAGEMENT | 483 | ||
| THE WORLD HEALTH ORGANIZATION (WHO) THREE-STEP ANALGESIC LADDER | 483 | ||
| Step 1 | 483 | ||
| Step 2 | 484 | ||
| Step 2 to 3 | 484 | ||
| Step 3 | 485 | ||
| ADJUVANT ANALGESICS | 485 | ||
| ANTIDEPRESSANTS | 485 | ||
| ANTICONVULSANTS | 485 | ||
| ANTIARRHYTHMICS | 485 | ||
| TOPICAL DRUGS | 485 | ||
| NMDA RECEPTOR ANTAGONISTS | 485 | ||
| REGIONAL ANALGESIA | 486 | ||
| PHYSICAL THERAPY | 486 | ||
| PSYCHOLOGY | 486 | ||
| SPECIFIC CHRONIC PAIN CONDITIONS OF THE LOWER LIMB | 486 | ||
| Complex regional pain syndrome | 486 | ||
| REFERENCES | 487 | ||
| FURTHER READING | 487 | ||
| 20 Local anaesthesia | 489 | ||
| CHAPTER CONTENTS | 489 | ||
| KEYWORDS | 489 | ||
| INTRODUCTION AND BACKGROUND | 489 | ||
| BASIC CHEMISTRY AND PHARMACOLOGY | 490 | ||
| Membrane electrophysiology | 490 | ||
| CHOICE OF LOCAL ANAESTHETIC AND DOSAGE | 490 | ||
| Bupivacaine | 492 | ||
| Levobupivacaine | 492 | ||
| Etidocaine | 492 | ||
| Lidocaine | 492 | ||
| Mepivacaine | 492 | ||
| Prilocaine | 492 | ||
| Ropivacaine | 493 | ||
| LOCAL AND SYSTEMIC COMPLICATIONS AND TOXICITY | 493 | ||
| Local effects | 493 | ||
| Systemic effects | 493 | ||
| Central nervous system (CNS) | 493 | ||
| Cardiovascular system | 494 | ||
| Allergic reaction | 494 | ||
| Hepatic and renal function | 494 | ||
| Pregnancy | 494 | ||
| Drug interactions | 494 | ||
| LOCAL ANAESTHETICS IN PRACTICE | 494 | ||
| SPECIFIC SITES | 495 | ||
| Local infiltration | 495 | ||
| The digital block | 495 | ||
| The ray block | 497 | ||
| Posterior tibial nerve | 497 | ||
| The sural nerve (root index S1/S2) | 497 | ||
| Saphenous nerve (root index L3/L4) | 497 | ||
| The superficial peroneal (fibular) nerves (root index L4/L5, S1) | 498 | ||
| The deep peroneal (fibular) nerve (root index L4/L5, S1/S2) | 498 | ||
| The popliteal block | 498 | ||
| REFERENCES | 499 | ||
| FURTHER READING | 500 | ||
| 21 Nail surgery | 501 | ||
| CHAPTER CONTENTS | 501 | ||
| KEYWORDS | 501 | ||
| PHENOLISATION | 501 | ||
| Phenol | 501 | ||
| History | 502 | ||
| THE PHENOLISATION TECHNIQUE | 502 | ||
| Total nail avulsion | 502 | ||
| Partial nail avulsion | 503 | ||
| Postoperative management | 504 | ||
| SURGICAL PROCEDURES | 504 | ||
| Winograd procedure | 505 | ||
| Zadik’s procedure | 505 | ||
| Frost procedure | 505 | ||
| Terminal Syme’s amputation | 505 | ||
| AVULSION USING UREA | 506 | ||
| TREATMENT OF SUBUNGUAL EXOSTOSIS | 506 | ||
| REFERENCES | 507 | ||
| 22 Diagnostic imaging | 509 | ||
| CHAPTER CONTENTS | 509 | ||
| KEYWORDS | 509 | ||
| INTRODUCTION | 509 | ||
| IMAGING MODALITIES | 510 | ||
| MAGNETIC RESONANCE IMAGING | 510 | ||
| ULTRASOUND | 510 | ||
| IMAGING MODALITIES UTILISING IONISING RADIATION: SAFETY AND LEGISLATION | 511 | ||
| COMPUTERISED TOMOGRAPHY | 512 | ||
| FLUOROSCOPY | 512 | ||
| NUCLEAR MEDICINE IMAGING | 512 | ||
| PLAIN RADIOGRAPHY | 514 | ||
| COMMON RADIOGRAPHIC PROJECTIONS | 514 | ||
| The dorsoplantar projection (also known as the anteroposterior view) | 515 | ||
| Lateromedial oblique projection | 515 | ||
| Mediolateral oblique projection | 515 | ||
| Lateral projections | 515 | ||
| Digital projections | 516 | ||
| Sesamoid positioning | 516 | ||
| Tarsal and ankle projections | 517 | ||
| RADIOGRAPHIC CHARTING | 518 | ||
| RADIOGRAPHIC ASSESSMENT AND INTERPRETATION | 519 | ||
| DEVELOPMENTAL VARIANTS: NORMAL AND ABNORMAL | 523 | ||
| OSTEOCHONDRITIS OR OSTEONECROSIS? | 525 | ||
| BONE TUMOURS | 525 | ||
| BONES, JOINTS AND CONNECTIVE TISSUES | 528 | ||
| FRACTURES | 529 | ||
| REFERENCES | 530 | ||
| 23 Podiatric surgery | 533 | ||
| CHAPTER CONTENTS | 533 | ||
| KEYWORDS | 533 | ||
| INTRODUCTION | 534 | ||
| PATIENT SELECTION FOR SURGERY | 534 | ||
| PATIENT CONSENT | 535 | ||
| DIGITAL DEFORMITIES | 535 | ||
| Flexor stabilisation | 536 | ||
| Flexor substitution | 536 | ||
| Extensor substitution | 536 | ||
| Adducto varus deformity | 536 | ||
| Mallet toe | 536 | ||
| Surgical treatment | 536 | ||
| Excisional arthroplasty | 536 | ||
| Arthrodesis | 536 | ||
| Digital amputation | 537 | ||
| HALLUX VALGUS | 537 | ||
| Procedures | 537 | ||
| Simple bunionectomy | 537 | ||
| Distal metaphyseal procedures | 537 | ||
| Midshaft procedures | 537 | ||
| Basal procedures | 538 | ||
| Hallux procedures | 539 | ||
| Evaluation | 539 | ||
| HALLUX VALGUS SYNDROME | 540 | ||
| MORTON’S NEUROMA | 542 | ||
| LESSER METATARSAL OSTEOTOMIES | 542 | ||
| HALLUX RIGIDUS | 543 | ||
| SESAMOID PROBLEMS | 543 | ||
| SKIN PLASTIES | 544 | ||
| REARFOOT SURGERY | 544 | ||
| SUTURE MATERIALS | 544 | ||
| SUTURE TECHNIQUES | 544 | ||
| Simple interrupted sutures | 544 | ||
| Mattress sutures | 544 | ||
| Cross-over sutures | 545 | ||
| Continuous sutures | 545 | ||
| TISSUE HANDLING | 545 | ||
| POSTOPERATIVE DRESSINGS | 545 | ||
| The inner or contact layer | 546 | ||
| The middle layer | 546 | ||
| The outer layer | 546 | ||
| The surface layer | 546 | ||
| When to re-dress | 546 | ||
| POSTOPERATIVE COMPLICATIONS | 546 | ||
| Infection | 546 | ||
| Swelling | 547 | ||
| Dehiscence | 547 | ||
| Haematoma | 547 | ||
| Joint stiffness | 548 | ||
| Hypertrophic scarring | 548 | ||
| Transfer metatarsalgia | 548 | ||
| Avascular necrosis | 548 | ||
| Chronic regional pain syndrome | 549 | ||
| REFERENCES | 549 | ||
| 24 Principles of infection control | 551 | ||
| CHAPTER CONTENTS | 551 | ||
| KEYWORDS | 551 | ||
| INFECTION TERMINOLOGY | 552 | ||
| Pathogen | 552 | ||
| Infection | 552 | ||
| Infective dose | 552 | ||
| Colonisation | 552 | ||
| Carriers | 552 | ||
| Sources of infection | 552 | ||
| Vehicles of infection | 552 | ||
| Cross-infection | 552 | ||
| Portals of entry | 552 | ||
| Portals of exit | 553 | ||
| Normal flora of the body | 553 | ||
| CHIEF SOURCES AND RESERVOIRS OF INFECTION | 553 | ||
| Endogenous sources | 553 | ||
| Exogenous sources | 553 | ||
| Infected or colonised people | 553 | ||
| Infected or colonised animals | 553 | ||
| Environmental sources and reservoirs | 553 | ||
| TRANSMISSION OF INFECTION | 554 | ||
| Direct transmission | 554 | ||
| Indirect transmission routes | 554 | ||
| Transmission by clinical items | 554 | ||
| Airborne transmission | 554 | ||
| Transmission by animals | 554 | ||
| Faecal transmission | 554 | ||
| HEPATITIS B VIRUS (HBV), HEPATITIS C VIRUS (HCV) AND HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTIONS | 554 | ||
| Hepatitis B and hepatitis C viruses (HBV and HCV) | 555 | ||
| HIV and AIDS | 555 | ||
| Implications for podiatrists | 555 | ||
| VARIANT CREUTZFELDT–JAKOB DISEASE | 556 | ||
| INFECTION CONTROL | 556 | ||
| Terminology | 556 | ||
| Sterilisation | 556 | ||
| Disinfection | 556 | ||
| Antisepsis | 556 | ||
| Asepsis | 556 | ||
| STRATEGIES AND METHODS OF CONTROL | 556 | ||
| Elimination of sources and reservoirs | 557 | ||
| Disruption of transmission routes | 557 | ||
| Cleaning | 557 | ||
| Disinfection | 558 | ||
| Disinfection by hot water | 558 | ||
| Disinfection by chemicals | 558 | ||
| Types of chemical disinfectant | 559 | ||
| Phenolic compounds | 559 | ||
| Chlorine compounds | 559 | ||
| Iodine compounds | 559 | ||
| Alcohols | 559 | ||
| Biguanide compounds | 559 | ||
| Triclosan (2,4,4´-trichloro-2´-hydroxydiphenylether) | 559 | ||
| Quaternary ammonium compounds | 559 | ||
| Glutaraldehyde | 560 | ||
| Hexachlorophane | 560 | ||
| Disinfection of specific items | 560 | ||
| Skin disinfection | 560 | ||
| Hands | 560 | ||
| Patients’ skin | 560 | ||
| Sterilisation | 561 | ||
| Steam at increased pressure | 561 | ||
| Dry heat | 561 | ||
| Glass bead sterilisers | 561 | ||
| FURTHER MICROBIOLOGICAL ASPECTS OF CLINICAL WORK | 561 | ||
| Protective clothing | 561 | ||
| Aseptic technique | 562 | ||
| Sterile fields | 562 | ||
| Dressing changes | 562 | ||
| Waste disposal | 562 | ||
| Operating rooms | 562 | ||
| Laboratory specimens | 563 | ||
| INFECTION-CONTROL POLICIES | 563 | ||
| REFERENCES | 563 | ||
| FURTHER READING | 564 | ||
| 25 Medical emergencies in podiatry | 565 | ||
| CHAPTER CONTENTS | 565 | ||
| KEY WORDS | 565 | ||
| CLINICAL ASSESSMENT | 565 | ||
| CLINICAL MONITORING | 566 | ||
| EMERGENCY DRUGS AND EQUIPMENT | 566 | ||
| PREDICTABLE EVENTS | 567 | ||
| Cardiovascular: angina (ischaemic heart disease)/myocardial infarction | 567 | ||
| Hypertension | 568 | ||
| Dysrhythmia | 568 | ||
| Heart valves/stents | 568 | ||
| Respiratory | 568 | ||
| Asthma | 568 | ||
| Chronic obstructive pulmonary disease | 568 | ||
| Endocrine | 568 | ||
| Diabetes | 568 | ||
| Hypoglycaemia | 569 | ||
| Hyperglycaemia | 569 | ||
| Hepatic/renal | 569 | ||
| Renal failure | 569 | ||
| Hepatic disease | 569 | ||
| Central nervous system | 569 | ||
| Transient ischaemic attack/stroke | 569 | ||
| Epilepsy | 569 | ||
| Minor fits | 569 | ||
| Major fits | 569 | ||
| UNPREDICTABLE EVENTS | 569 | ||
| Vasovagal syncope | 570 | ||
| Cardiac arrest | 570 | ||
| Allergy/anaphylaxis | 571 | ||
| Local anaesthetic toxicity | 571 | ||
| SUMMARY | 572 | ||
| FURTHER READING | 572 | ||
| 26 Evolution and its influence on human foot function | 573 | ||
| CHAPTER CONTENTS | 573 | ||
| KEY WORDS | 573 | ||
| INTRODUCTION | 573 | ||
| SOME LARGE-SCALE DIFFERENCES BETWEEN THE HOMINOIDEA | 575 | ||
| A comparison of gait cycles | 575 | ||
| The functional adaptation of the midtarsal joint and the medial and lateral columns | 575 | ||
| The functional transformation of the subtalar joint | 576 | ||
| Orientation of the medial metatarsal–cuneiform joint | 576 | ||
| Relative robusticity of the metatarsals | 577 | ||
| Torsion of the metatarsal shafts | 577 | ||
| Morphology of the metatarsal heads | 577 | ||
| EVOLUTIONARY BASIS FOR SOME CLINICAL DISORDERS OF THE HUMAN FOOT | 578 | ||
| REFERENCES | 578 | ||
| 27 Health promotion and patient education | 581 | ||
| CHAPTER CONTENTS | 581 | ||
| KEYWORDS | 581 | ||
| INTRODUCTION | 581 | ||
| THE PODIATRIST’S ROLE AS A HEALTH PROMOTER/EDUCATOR | 582 | ||
| PATIENT EDUCATION | 583 | ||
| EVIDENCE-BASED PRACTICE | 585 | ||
| CONCLUSIONS | 585 | ||
| REFERENCES | 586 | ||
| 28 Clinical governance | 589 | ||
| CHAPTER CONTENTS | 589 | ||
| KEYWORDS | 589 | ||
| INTRODUCTION | 589 | ||
| CHRONOLOGY | 589 | ||
| BACKGROUND | 591 | ||
| ASPECTS | 591 | ||
| Quality planning | 592 | ||
| Workforce planning and developing the workforce | 592 | ||
| Information technology | 593 | ||
| Research | 593 | ||
| Poor performance | 593 | ||
| Learning from experience | 593 | ||
| Risk management | 594 | ||
| Consent and informed consent | 594 | ||
| REFERENCES | 594 | ||
| 29 Health and safety in podiatric practice | 595 | ||
| CHAPTER CONTENTS | 595 | ||
| KEYWORDS | 595 | ||
| INTRODUCTION | 596 | ||
| EFFECTIVE MANAGEMENT | 597 | ||
| SUCCESSFUL HEALTH AND SAFETY MANAGEMENT | 597 | ||
| SAFETY CULTURE | 597 | ||
| SAFE SYSTEMS OF WORK | 597 | ||
| LEGAL DUTIES | 598 | ||
| THE EMPLOYER’S RESPONSIBILITY TO VARIOUS PARTIES | 599 | ||
| Employees | 599 | ||
| Responsibilities of employees | 599 | ||
| Trainees (i.e. student podiatrists on work experience or a placement) | 599 | ||
| Health surveillance | 599 | ||
| Visitors and the general public | 599 | ||
| Trespassers | 600 | ||
| HEALTH AND SAFETY POLICY | 600 | ||
| General statement of intent | 600 | ||
| Health and safety at work responsibilities | 600 | ||
| Administration of health and safety at work | 600 | ||
| RISK ASSESSMENTS | 600 | ||
| Record-keeping requirements | 601 | ||
| Safe systems of work | 601 | ||
| Accident procedures | 601 | ||
| Working environment | 601 | ||
| Control of chemicals | 601 | ||
| Fire safety | 601 | ||
| Physical agents/stored energy | 602 | ||
| Plant and equipment | 602 | ||
| Handling operations | 602 | ||
| Risk assessment | 602 | ||
| Principles of risk assessment | 602 | ||
| Problem-solving and decision-making | 602 | ||
| Evaluation and expression of risk | 603 | ||
| Residual risk | 603 | ||
| Expressions to identify risk | 603 | ||
| Principles for risk control | 603 | ||
| Basis for assessment | 603 | ||
| Five steps to risk assessment | 604 | ||
| Step 1. Look for hazards | 604 | ||
| Step 2. Decide who might be harmed, and how | 604 | ||
| Step 3. Evaluate the risks from the hazards and decide whether existing precautions are adequate or whether more is required | 604 | ||
| Step 4. Record findings | 604 | ||
| Step 5. Review assessments on a regular basis and revise when necessary | 604 | ||
| Using risk factors to evaluate risk | 604 | ||
| Likelihood of occurrence rating | 605 | ||
| Expressing priorities for risk control | 605 | ||
| Limits of reasonable practicability | 605 | ||
| So far as is practicable | 605 | ||
| Refinement of risk factors to help apply control principles | 605 | ||
| Checklist for risk assessments | 605 | ||
| Generic risk assessments | 605 | ||
| LEGAL REQUIREMENTS WHERE RISK ASSESSMENT IS SPECIFIED – SPECIFIC RISKS | 606 | ||
| Noise at Work Regulations 2005 | 606 | ||
| Health and Safety (Display Screen Equipment) Regulations 1992 (as amended 2002) | 606 | ||
| Manual Handling Operations Regulations 1992 (as amended 2002) | 606 | ||
| Personal Protective Equipment at Work Regulations 1992 (as amended 2005) | 606 | ||
| Control of Substances Hazardous to Health Regulations 2002 | 606 | ||
| Management of Health and Safety at Work (Amendment) Regulations 1999 | 606 | ||
| The Regulatory Reform (Fire Safety) Order 2005 | 606 | ||
| Health and Safety (First Aid) Regulations 1981 | 606 | ||
| REFERENCES | 606 | ||
| Index | 607 | ||
| A | 607 | ||
| B | 608 | ||
| C | 608 | ||
| D | 609 | ||
| E | 609 | ||
| F | 610 | ||
| G | 611 | ||
| H | 611 | ||
| I | 612 | ||
| J | 612 | ||
| K | 612 | ||
| L | 612 | ||
| M | 613 | ||
| N | 613 | ||
| O | 614 | ||
| P | 614 | ||
| Q | 615 | ||
| R | 615 | ||
| S | 616 | ||
| T | 617 | ||
| U | 618 | ||
| V | 618 | ||
| W | 618 | ||
| X | 618 | ||
| Y | 618 | ||
| Z | 618 | ||
| Inside Back Cover | ibc1 |