Neale's Disorders of the Foot

Name: Neale's Disorders of the Foot
Brand: Churchill Livingstone
Availability: OnlineOnly

Paul Frowen Maureen O'Donnell J. Gordon Burrow(Autor*in)

Churchill Livingstone (Verlag)

8. Auflage

Erschienen am 12. April 2010

716 Seiten

E-Book

ePUB mit Adobe-DRM

Systemvoraussetzungen

E-Book

PDF mit Adobe-DRM

Systemvoraussetzungen

E-Book

ePUB mit Wasserzeichen-DRM

Systemvoraussetzungen

978-0-7020-4428-1 (ISBN)

ab 77,34 €

Als Download verfügbar

Merkliste: siehe Preise

Beschreibung

Alle Preise

Weitere Details

Weitere Ausgaben

Inhalt

Front Cover
Inside Front Cover
half-title
Neale's Disorders of the Foot
Copyright
TOC
Web Contents and Evolve information
Foreword
Preface to Eighth Edition
Preface to First Edition
Acknowledgements
Contributors
1 Examination and diagnosis in clinical management
CHAPTER CONTENTS
KEYWORDS
INTRODUCTION
GATHERING DATA
TAKING A COMPREHENSIVE PODIATRIC HISTORY
ELEMENTS OF THE HISTORY
Introductory information
Chief complaints - soliciting contribution
Past medical history
Drug/medication history
Social history
Family history
Review of systems
ATTRIBUTES OF SYMPTOMS
PERFORMING THE PHYSICAL EXAMINATION
Mental status
Skin (see also Chs 2 and 3)
Nails (see also Ch. 3)
Swellings
Musculoskeletal system (see also Ch. 8)
Footwear (see also Ch. 18)
Vascular assessment (see also Ch. 12)
Neurological assessment (see also Ch. 6)
Motor system
Inspection
Palpation and assessment of tone
Assessment of power
Assessment of reflexes
Assessment of coordination
Motor and sensory system functions
Sensory investigations
Light touch
Pin prick
Vibration
Gait
Static evaluation
Dynamic evaluation
Other soft tissues
Biomechanical examination
Further investigations
Discharge
Skin and nail
APPLYING CRITICAL THINKING TO THE INFORMATION GATHERED
DEVELOPMENT OF THE DIAGNOSIS
CREATING THE RECORD
REFERENCES
2 The skin and nails in podiatry
CHAPTER CONTENTS
KEYWORDS
AFFECTATIONS OF THE SKIN
STRUCTURE AND FUNCTION OF THE SKIN
ACUTE INFLAMMATION
CHRONIC WOUNDS (ULCERS)
Assessment of chronic wounds
Pathogenesis of chronic wounds
Management of chronic wounds
SCARRING
BURNS
ATROPHY
CHILBLAINS AND CHILLING
INFECTIONS AND THE SKIN
Bacterial infections
Systemic bacterial infections
Common skin bacteria and resultant conditions
Features of cutaneous infections
Management of bacterial infection in the skin
Viral infections
Verrucae/warts
Clinical features of verrucae (warts)
Single plantar wart (verruca)
Mosaic warts
Management
Topical preparations for wart treatment
Electrosurgery
Parasitic infestations
VITILIGO
DISORDERS OF SWEATING
FISSURES
CORNS AND CALLUS
Pathogenesis of corns and callus
Management of corns and callus
BURSITIS
THE SKIN AS AN INDICATOR OF PSYCHOLOGICAL DISTURBANCE
THE NAIL IN HEALTH AND DISEASE
Embryonic development and nail growth
Blood supply and innervation
INVOLUTION (PINCER, OMEGA NAIL)
Aetiology
Treatment
ONYCHOCRYPTOSIS (INGROWING TOENAIL)
Aetiology
Treatment
SUBUNGUAL EXOSTOSIS
Pathology
Treatment
SUBUNGUAL HELOMA (CORN)
Aetiology
Treatment
SUBUNGUAL MELANOMA
Aetiology
Treatment
ONYCHAUXIS (HYPERTROPHIED NAIL)
Aetiology
Pathology
Treatment
ONYCHOGRYPHOSIS (RAM'S HORN, OSTLER'S TOE)
Aetiology
Pathology
Treatment
ONYCHOPHOSIS
Aetiology
Treatment
PARONYCHIA
Aetiology
Pathology
Treatment
ONYCHIA
Aetiology
Pathology
Treatment
ONYCHOLYSIS
Aetiology
Pathology
Treatment
ONYCHOMADESIS (ONYCHOPTOSIS, APLASTIC ANONYCHIA)
Aetiology
Treatment
ONYCHATROPHIA (ANONYCHIA)
ONYCHORRHEXIS (REED NAIL)
BEAU'S LINES
Aetiology
Treatment
HIPPOCRATIC NAILS (CLUBBING)
KOILONYCHIA (SPOON-SHAPED NAIL)
ONYCHOMYCOSIS (TINEA UNGUIUM)
Aetiology
Pathology
Treatment
LEUCONYCHIA
YELLOW NAIL SYNDROME
PTERYGIUM
REFERENCES
FURTHER READING
3 Dermatological conditions of the foot and leg
CHAPTER CONTENTS
KEYWORDS
Inflammatory skin diseases
PSORIASIS AND RELATED DISORDERS
Treatment
Palmoplantar pustular psoriasis (PPP)
REITER'S DISEASE
PITYRIASIS RUBRA PILARIS (PRP)
ECZEMA (DERMATITIS) AND RELATED DISORDERS
Atopic eczema
Treatment
Contact dermatitis
Stasis and varicose eczema
Pompholyx
Juvenile plantar dermatosis
LICHEN PLANUS
ICHTHYOSIS
KERATODERMAS
Inherited palmoplantar keratodermas
Aetiology
Clinical features
Treatment
Acquired keratoderma
Keratoderma climactericum
Acrokeratosis paraneoplastica (Bazex's syndrome)
Keratoderma and hypothyroidism
Blistering disorders
EPIDERMOLYSIS BULLOSA: THE INHERITED MECHANOBULLOUS DISORDERS
AUTOIMMUNE BLISTERING DISORDERS
Tumours
CAUSES OF SKIN TUMOURS
EPIDERMAL TUMOURS
Seborrhoeic keratosis
Aetiology
Clinical features
Histology
Treatment
Bowen's disease
Clinical features
Histology
Treatment
Basal cell carcinoma
Clinical features
Histology
Treatment
Squamous cell carcinoma
Aetiology
Clinical features
Squamous cell carcinoma variant: verrucose carcinoma of the foot
Histology
Treatment
CUTANEOUS METASTATIC DISEASE
Clinical features
Histology
Treatment
PIGMENTED SKIN LESIONS
Naevus
Classification of pigmented lesions
Freckles
Lentigo
Congenital melanocytic naevus
Clinical features
Histology
Treatment
Acquired melanocytic naevus
Clinical features
Intradermal naevi
Histology
Treatment
Speckled and lentiginous naevus
Clinical features
Histology
Treatment
Becker's naevus
Clinical features
Histology
Treatment
Spitz naevus
Clinical features
Histology
Treatment
Dysplastic naevi
Clinical features
Histology
Treatment
Malignant melanoma of the skin
Aetiology
Clinical features
Histology
Treatment
Epidermal naevi
Clinical features
Histology
Treatment
Dermal and subcutaneous naevi
VASCULAR TUMOURS
Pyogenic granuloma
Clinical features
Histology
Treatment
Glomus tumour
Clinical features
Histology
Treatment
Kaposi's sarcoma
Aetiology
Clinical features
Histology
Treatment
FIBROUS TUMOURS
Acquired fibrokeratoma
Aetiology
Clinical features
Histology
Treatment
Koenen's tumours
Dermatofibroma
Aetiology
Clinical features
Histology
Treatment
Dermatofibrosarcoma protuberans
Clinical features
Histology
Treatment
ADNEXAL TUMOURS
Eccrine poroma
Aetiology
Clinical features
Histology
Treatment
OTHER STRUCTURES
Leiomyoma
Clinical features
Histology
Treatment
Subungual exostosis
Aetiology
Clinical features
Histology
Treatment
Myxoid cyst
Aetiology
Clinical features
Histology
Treatment
Ganglia
Clinical features
Histology
Treatment
Bursae
Clinical features
Treatment
Piezogenic pedal papules
Clinical features
Treatment
Neurofibromatosis
Clinical features
Histology
Treatment
Fungal infections of the feet and nails
DERMATOPHYTE INFECTION
Epidemiology
Clinical types
Toe cleft infection
Moccasin tinea pedis
DIFFERENTIAL DIAGNOSIS OF FOOT INFECTION
NAIL INFECTION
Clinical types
Distal and lateral subungual onychomycosis (DLSO)
Superficial white onychomycosis (SWO)
Proximal subungual onychomycosis (PSO)
Total dystrophic onychomycosis (TDO)
Candidal onychomycosis (CO)
Tinea incognito
LABORATORY DIAGNOSIS OF DERMATOPHYTE INFECTION
TREATMENT OF FUNGAL FOOT AND NAIL INFECTIONS
Systemic treatment of foot and nail infections
Safety
Prophylaxis
REFERENCES
4 Adult foot disorders
CHAPTER CONTENTS
KEYWORDS
CLINICAL BIOMECHANICS
The neutral or reference position
The principle of compensation
The gait or walking cycle
Activity of the muscles and joints of the limb in gait
LOWER LIMB AND FOOT ANOMALIES
FRONTAL PLANE ANOMALIES OF THE LOWER LIMB AND FOOT
Leg-length discrepancy
Incidence of LLD
Causes of LLD
Effects of LLD
Symptoms of LLD
Significance of the degree of LLD
Assessment and measurement of LLD
Management of LLD
The inverted or varus rearfoot
Coxa valgum, genu vara, tibia vara (bowleg)
Rearfoot varus
Causes of rearfoot varus
Classifications of rearfoot varus
Compensatory mechanisms in rearfoot varus
Other compensatory mechanisms in rearfoot varus
Uncompensated rearfoot varus
Signs and symptoms of an uncompensated rearfoot varus
Fully compensated rearfoot varus
Signs and symptoms of fully compensated rearfoot varus
Partially compensated rearfoot varus
Signs and symptoms of partially compensated rearfoot varus
Treatment of rearfoot varus
Varus rearfoot
The inverted or varus forefoot
Forefoot varus
Causes of forefoot varus
Classifications of forefoot varus
Compensatory mechanisms in forefoot varus
Fully compensated forefoot varus
Signs and symptoms of fully compensated forefoot varus
Uncompensated forefoot varus
Signs and symptoms of uncompensated forefoot varus
Partially compensated forefoot varus
Signs and symptoms of partially compensated forefoot varus
Treatment of forefoot varus
Forefoot supinatus
Causes of forefoot supinatus
Clinical recognition of forefoot supinatus
Treatment of forefoot supinatus
The everted or valgus rearfoot
Coxa vara and genu valga/valgum (knock knees)
True rearfoot valgus
The valgus rearfoot
The everted or valgus forefoot
Forefoot valgus
Causes of forefoot valgus
Classification of forefoot valgus
Rigid-type forefoot valgus
Signs and symptoms of rigid forefoot valgus
Mobile type forefoot valgus
Signs and symptoms of mobile forefoot valgus
Treatment of forefoot valgus
SAGITTAL PLANE ANOMALIES OF THE LOWER LIMB AND FOOT
Pelvic nutation
Genu recurvatum
Ankle equinus
Aetiology and presentations of ankle equinus
Classification of ankle equinus
Treatment of ankle equinus
Plantar flexed first metatarsal
Hallux limitus/rigidus
Aetiology of hallux limitus
Intrinsic factors
Extrinsic factors
Pathology of hallux limitus
Reduction in normal foot function, as the result of first ray anomalies
Pathophysiological effects of a reduced range of motion at the first metatarsophalangeal joint
Classification of hallux limitus
Clinical picture of hallux limitus
Gait and posture effects of structural hallux limitus
Pain associated with hallux limitus and hallux rigidus
Shoe-wear marks
Diagnosis and differential diagnoses
Treatment of hallux limitus and hallux rigidus
Conservative treatments
Surgical treatment of hallux limitus and hallux rigidus
Hallux flexus (acute hallux limitus)
Pathology of hallux flexus
Diagnosis of hallux flexus
Treatment of hallux flexus
Functional hallux limitus
Sagittal plane blockade
Hypermobile medial column/first ray
Metatarsus primus elevatus
Plantar-flexed fifth metatarsal
ABNORMALITIES OF ARCH HEIGHT
Pes planus
Classification of pes planus
Consequences of pes planus
Treatment of pes planus
Pes cavus
Aetiology of pes cavus
Treatment of pes cavus
TRANSVERSE PLANE ANOMALIES OF THE LOWER LIMB AND FOOT
Hallux abducto valgus
Normal anatomy of the first ray
Planar movements at the normal first metatarsophalangeal joint
Incidence of hallux abducto valgus
Aetiology of hallux abducto valgus
Factors that predispose to the development of hallux abducto valgus
Intrinsic factors
Extrinsic factors
Variants of normal foot anatomy
Metatarsus primus varus
Relative length of the first metatarsal
Decreased muscular function
Iatrogenic or idiopathic features
Pathology of hallux abducto valgus
Excessive or prolonged foot pronation
Pronation and supination in the first ray
Change in the orientation of the skeletal and soft tissue components that make up the first ray
The influence of the position of the sesamoid complex (Fig 4.13)
Dysfunction of soft tissue structures in hallux abducto valgus
Clinical picture in hallux abducto valgus
Clinical examination in hallux adducto valgus
Non-weight-bearing examination
Standing examination
Diagnosis of hallux abducto valgus
Treatment of hallux abducto valgus
Conservative and symptomatic management of nail and soft tissue pathologies
Orthotic therapy
Surgical correction of the forefoot deformity
OTHER FOOT DISORDERS
Osteochondrosis/osteochondritis
Classification
Aetiology
Diagnosis
Differential diagnosis
Treatment
Freiberg's disease (Freiberg's infraction)
Pathology
Clinical picture
Diagnosis and differential diagnosis
Treatment
Kohler's disease
Pathology
Clinical picture
Diagnosis and differential diagnosis
Treatment
Osteochondritis dissicans of the talus
Pathology
Clinical picture
Diagnosis and differential diagnosis
Treatment
Sever's disease
Pathology
Clinical picture
Diagnosis and differential diagnoses
Treatment
Iselin's disease
REARFOOT DISORDERS
Posterior heel pain
Superficial retrocalcaneal bursitis
Pathology
Clinical features
Diagnosis and differential diagnosis
Treatment
Deep retrocalcaneal bursitis
Pathology
Clinical feature
Diagnosis and differential diagnoses
Treatment
Achilles tendonitis
Pathology
Clinical picture
Diagnosis and differential diagnosis
Treatment
Rupture and partial rupture of the Achilles tendon
Pathology
Clinical picture
Treatment
Plantar heel pain
Heel pain syndrome
Pathology
Clinical picture
Diagnosis and differential diagnosis
Other causes of plantar heel pain
Subcalcaneal bursitis
Entrapment neuropathy
Radiculopathy of the first sacral spinal nerve (s1 radiculopathy)
Treatment of plantar heel pain
Tarsal tunnel syndrome
Pathology
Clinical features
Treatment
Tibialis posterior tendon dysfunction
Aetiology
Pathology
Clinical picture
Diagnosis and differential diagnosis
Treatment
Conservative therapies
Surgical procedures
Tarsal coalition
Pathology
Clinical presentation
Diagnosis and differential diagnoses
Treatment
MIDFOOT DISORDERS
Plantar fibromatosis
Pathology
Clinical features
Diagnosis and differential diagnosis
Treatment
Tarsal arthritis
Pathology
Clinical picture
Diagnosis and differential diagnoses
Treatment
Plantar fasciitis
Pathology
Clinical picture
Diagnosis and differential diagnosis
Treatment
FOREFOOT DISORDERS: METATARSALGIA
Classification of metatarsalgia
Functional metatarsalgia
Pathology
Clinical presentation
Management
Non-functional metatarsalgia
Categorisation of non-functional metatarsalgia
Focal hyperkeratoses
Metatarsalgia relating to soft tissue pathologies
Pathology
Clinical picture
Diagnosis
Treatment
Metatarsalgia due to synovial tissue pathologies
Ganglia/ganglionic cysts
Pathology
Clinical picture
Treatment
Capsulitis
Pathology
Treatment
Gouty tophus
Pathology
Clinical picture
Diagnosis
Treatment
Problematic bursae
Treatment
Rheumatoid nodules and rheumatoid bursae
Pathology
Clinical picture
Treatment
Plantar plate rupture
Pathology
Clinical picture
Diagnosis and differential diagnoses
Treatment
Neurological problems
Sensory problems, paraesthesia and painful neuropathy
Nerve entrapment/Morton's neuroma
Pathology
Compression and tension of the plantar digital nerves
Distal extension of the intermetatarsal bursa
Transient ischaemia
Biomechanical influences
Clinical picture
Diagnosis and differential diagnosis
Treatment
Metatarsalgia arising in association with bone pathologies
Stress fracture
Pathology
Signs that indicate a stress fracture
Factors that predispose to stress fracture
Diagnosis
Treatment
March fracture
Clinical picture
Diagnosis and differential diagnosis
Treatment
Principles of recognition and treatment of stress fractures elsewhere in the foot
Sesamoid pathologies
Relationship of flexor hallucis brevis sesamoids and the first metatarsal head
Clinical picture
Diagnosis and differential diagnosis
Treatment
Sesamoid fractures
Sesamoid osteochondritis
Freiberg's infraction
Complications following metatarsal surgery
Systemic diseases that may give rise to metatarsalgia
Rheumatological diseases
Arthropathies
Osteoarthritis
Rheumatoid arthritis
Ankylosing spondylitis
Connective tissue disorders
Infective and reactive arthritis
Arthropathy associated with other disease states
Other causes of metatarsalgia
Plantar fibromatosis
Altered tissue perfusion and reduced vascular drainage
Generalised muscular pathology
Neoplastic disease
Back pain
Soft tissue effects of rheumatic disease
Miscellaneous systemic causes of metatarsalgia
REFERENCES
5 Circulatory disorders
CHAPTER CONTENTS
KEYWORDS
INTRODUCTION
ARTERIOSCLEROSIS (HARDENING OF THE ARTERIES)
ATHEROSCLEROSIS (MACROVASCULAR DISEASE)
Epidemiology
Pathology
RISK FACTORS
Modifiable factors
Smoking
Lipid disorders
Primary hyperlipidaemias
Secondary hyperlipidaemias
Diabetes mellitus
Hypertension
Obesity
Homocysteine
Haemostatic variables
Sedentary lifestyle
Dietary deficiencies of antioxidant vitamins and polyunsaturated fatty acids
Type A behaviour pattern (TABP)
Fixed factors
Age and sex
Family history
CLINICAL FEATURES
Intermittent claudication
Rest pain
DIAGNOSIS
ASSESSMENT OF SKIN BLOOD FLOW
CLINICAL MANAGEMENT
Risk reduction
Smoking
Elevated cholesterol
Glycaemic control
Blood pressure control
Obesity
Antiplatelet therapy
Elevated homocysteine
Drug therapy
Exercise therapy
Alternative therapies
Vascular intervention
ACUTE ARTERIAL OCCLUSION
VASCULITIS
Thromboangiitis obliterans (Buerger's disease)
Epidemiology
Aetiology
Clinical features
Pathology
Differential diagnosis
Treatment
Prognosis
Polyarteritis nodosa
Clinical features
Differential diagnosis
Treatment
Rheumatoid vasculitis
VASOSPASTIC DISORDERS
Raynaud's phenomenon
Clinical features
Pathology
Treatment
ACROCYANOSIS
ERYTHOMELALGIA
LIVEDO RETICULARIS
ERYTHEMA ABIGNE
FROSTBITE
IMMERSION FOOT (TRENCH FOOT)
MICROVASCULAR DISEASE
VENOUS DISEASE
Deep venous thrombosis (DVT)
Clinical diagnosis
Clinical features
Treatment
PULMONARY THROMBOEMBOLISM
SUPERFICIAL THROMBOPHLEBITIS
CHRONIC VENOUS STASIS
Clinical features
Treatment
LYMPHATIC DISEASE
LYMPHOEDEMA
Primary lymphoedema (Milroy's disease)
Secondary lymphoedema
Clinical features
Diagnosis
Treatment
FURTHER READING
6 Neurological disorders in the lower extremity
CHAPTER CONTENTS
KEYWORDS
THE SPINAL CORD PATHWAYS AND CLINICAL EXAMINATION
Ascending pathways
Descending pathways
PERIPHERAL NERVE INJURY
PERIPHERAL ENTRAPMENT NEUROPATHIES
HEREDITARY MOTOR AND SENSORY NEUROPATHIES
SPINAL RADICULOPATHIES
CHARACTERISTICS OF CEREBELLAR LESIONS
CHARACTERISTICS OF BASAL GANGLIA LESIONS
Hyperkinetic dyskinesias
Huntington's chorea
Sydenham's chorea or St Vitus' dance
Hypokinetic dyskinesias
Parkinsonism
CEREBRAL PALSY
AUTONOMIC NERVOUS SYSTEM
Sympathetic nervous system dysfunction in the lower extremity
DIABETIC PERIPHERAL NEUROPATHY
CHARCOT JOINT DISEASE
DISORDERS OF NEUROMUSCULAR TRANSMISSION
REFERENCES
FURTHER READING
Peripheral nerve injury
Low back pain
Hereditary motor and sensory neuropathies
Entrapment neuropathies
Cerebellar lesions
Basal ganglion disease
Cerebral palsy
Diabetic neuropathy
Complex regional pain syndrome
Myasathenic syndromes
7 Podiatry in the management of leprosy and tropical diseases
CHAPTER CONTENTS
KEYWORDS
INTRODUCTION
LEPROSY
Epidemiology
Classification
Neuropathy in tuberculoid leprosy
Neuropathy in lepromatous leprosy
Neuropathy in borderline (dimorphous) leprosy
The lower limb in Hansen's disease
Anaesthesia
Factors associated with plantar ulceration
Motor paralysis
Claw toes
Extrinsic muscle paralysis
Pre-existing pathomechanical foot function
Tarsal disintegration
Absorption and pathological fractures
Autonomic impairment
Social and behavioural variables
Complications of ulceration
Secondary infection
Squamous-cell carcinoma
Treatment of pedal pathologies
Ulceration
The active phase of ulceration
The proliferative phase of ulceration
The maturation or remodelling phase of ulceration
Mal perforans
Enhancing the healing process
Infection control
Maintaining an optimal wound environment
Rest
Orthotic options
Case studies
TROPICAL DISEASES
Bacterial infections
Pyogenic infections
Aetiology and pathogenesis
Clinical findings and diagnosis
Management and treatment
Treponemal infections
Other bacterial infections manifesting on the foot
Mycobacterial infections
Aetiology and pathogenesis
Clinical findings and diagnosis
Fish-tank granuloma
Leprosy
Skin tuberculosis
Buruli ulcer
Management and treatment of mycobacterial infections
Bacterial mycetoma
Aetiology and pathogenesis
Clinical findings and diagnosis
Management and treatment
Parasitic diseases, ectoparasite infestations and bites
Cutaneous larva migrans
Aetiology and pathogenesis
Clinical findings and diagnosis
Management and treatment
Leishmaniasis
Aetiology and pathogenesis
Clinical findings and diagnosis
Management and treatment
Gnathostomiasis
Aetiology and pathogenesis
Clinical findings and diagnosis
Management and treatment
Tungiasis
Aetiology and pathogenesis
Clinical findings and diagnosis
Management and treatment
Myasis
Aetiology and pathogenesis
Clinical findings and diagnosis
Management and treatment
Scabies
Aetiology and pathogenesis
Clinical findings and diagnosis
Management and treatment
Ticks
Aetiology and pathogenesis
Clinical findings and diagnosis
Management and treatment
Fleas
Aetiology and pathogenesis
Clinical findings and diagnosis
Management and treatment
Fungal conditions
Eumycetoma
Aetiology and pathogenesis
Clinical findings and diagnosis
Management and treatment
Chromoblastomycosis
Aetiology and pathogenesis
Clinical findings and diagnosis
Management and treatment
Dermatophytes
Aetiology and pathogenesis
Clinical findings and diagnosis
Management and treatment
Systemic mycosis manifesting on the feet
Coccidioidomycosis
Paracoccidioidomycosis
Viral infections
Miscellaneous conditions
Ainhum
Pellagra
Drug reactions, chronic dermatitis and other skin conditions
Seaborne conditions
REFERENCES
Further reading
8 Musculoskeletal disorders
CHAPTER CONTENTS
KEYWORDS
INTRODUCTION
DEFINING RHEUMATOLOGY AND THE MUSCULOSKELETAL DISEASES
GENERAL EPIDEMIOLOGY OF RHEUMATIC CONDITIONS
BURDEN OF DISEASE
THE EPIDEMIOLOGY OF FOOT PROBLEMS GENERALLY AND IN RHEUMATOLOGY
A BRIEF OVERVIEW OF DEVELOPMENTS IN MEDICAL RHEUMATOLOGY
MEDICAL MANAGEMENT IN RHEUMATOLOGY - OVERVIEW ACROSS DISEASES
THE FOOT IN RHEUMATOLOGY - OVERVIEW ACROSS DISEASES
Assessing the foot
Management principles
Provision of foot health services - current provision, multidisciplinary involvement, surgery
Service provision
Education and self-management advice
General foot care, nail cutting, corn and callus reduction, provision of padding
High-risk management of the vasculitic or ulcerative foot
Extended scope practice and surgery
SPECIFIC DISEASES
Seropositive inflammatory arthritis
Rheumatoid arthritis
Definition
Epidemiology
Diagnosis
Pathology
Clinical course
Medical management
The foot in rheumatoid arthritis
Hindfoot
Midfoot
Forefoot
Subcutaneous lesions
Skin and nails
Vasculitis
Juvenile idiopathic arthritis
Definition
Epidemiology
Classification
Diagnosis
Pathology
Clinical course
Medical management
The foot in juvenile idiopathic arthritis
Polyarticular type
Enthesitis-related arthritis and psoriatic arthritis
Seronegative inflammatory arthritis:
Introduction - common features
Ankylosing spondylitis (inflammatory back pain)
Definition
Epidemiology
Diagnosis
Pathology
Clinical course
Medical management
The foot in ankylosing spondylitis
Psoriatic arthritis
Definition
Epidemiology
Diagnosis
Pathology
Clinical course
Medical management
The foot in psoriatic arthritis
Reactive arthritis
Definition
Diagnosis
Medical management
The foot in reactive arthritis
Connective tissue diseases - scleroderma and lupus
Scleroderma
Definition
Epidemiology
Diagnosis
Clinical course
Medical management
The foot in scleroderma
Lupus
Definition
Epidemiology
Diagnosis
Pathology
Clinical course
Medical management
The foot in lupus
Osteoarthritis
Definition
Epidemiology
Diagnosis
Pathology
Clinical course
Medical management
The foot in osteoarthritis
Crystal arthropathies (gout and pseudogout)
Definition
Epidemiology
Diagnosis
Pathology
Clinical course
The foot in crystal arthropathies
Infective arthritis
The foot in infective arthritis
Other rheumatological conditions
Fibromyalgia
Definition
Polymyalgia rheumatica
Sjögren's syndrome
Joint hypermobility syndromes
Definition
Epidemiology
Diagnosis
Pathology
Clinical course
Medical management
The foot in hypermobility syndrome
Miscellaneous other conditions
ASSESSING OUTCOMES IN RHEUMATIC DISEASE
SUMMARY
ACKNOWLEDGEMENTS
REFERENCES
9 Metabolic disorders
CHAPTER CONTENTS
KEYWORDS
DIABETES MELLITUS
Type 1 diabetes
Type 2 diabetes
Secondary diabetes
Diagnosis
Clinical features
Treatment
Treatment of type 1 diabetes mellitus
Treatment of type 2 diabetes mellitus
Hypoglycaemia
Complications and control of diabetes
Eye disease
Background retinopathy
Proliferative retinopathy
Kidney disease
Neuropathy
Symmetrical sensory and autonomic neuropathy
Neuropathies that recover, mononeuropathies, radiculopathies and acute painful neuropathies
Pressure palsies
Symptomatic autonomic neuropathy
Symptoms
Diagnosis
Vascular disease
The diabetic foot
The neuropathic foot
Neuropathic ulcer
Complications of ulceration
Management of ulceration
Neuropathic (Charcot) joint
Management
Neuropathic oedema
The neuroischaemic foot
Pathogenesis
Presentation
Management
OBESITY
METABOLIC BONE DISEASE
Bone and calcium metabolism
Hormonal physiology
Hypercalcaemia
Hypocalcaemia
Osteoporosis
Osteomalacia and rickets
Hyperparathyroidism
Renal osteodystrophy
Paget's disease
METABOLIC DISORDERS AND PODIATRIC MANAGEMENT
REFERENCES
FURTHER READING
10 Management of high-risk patients
CHAPTER CONTENTS
KEYWORDS
AIMS IN MANAGING HIGH-RISK PATIENTS
PREVENTION OF COMPLICATIONS
History taking and assessment
General points regarding treatment
MANAGEMENT OF ESTABLISHED WOUNDS, INFECTION OR NECROSIS
Examination of the wound
Infection
Management of wounds
Desloughing and wound cleansing agents
Desloughing agents
Wound-cleansing agents and antiseptics
Antiseptics
Dressings
1. The ability to remove exudate
2. The ability to maintain humidity at the wound-dressing interface
3. Permeability of the dressing to gases
4. The ability to be impermeable to microorganisms
5. The ability to maintain a suitable temperature at the wound surface
6. The ability to maintain low adherence at the wound-dressing interface
7. The ability to be free from contaminants
8. The ability to maintain a suitable pH
9. Other factors, including patient acceptability, ease of application and comfort, and cost
Types of dressing for use in podiatric practice
Conventional dressings
Primary wound-dressing films
Semipermeable adhesive film dressings
Perforated film absorbent dressings
Low-adherent wound contact layers
Unmedicated
Medicated
Semipermeable hydrogels
Hydrocolloids
Alginate dressings
Polyurethane foams
Silver agents
Other dressings - the way forward?
OTHER ASPECTS OF MANAGEMENT
CONCLUSIONS
REFERENCES
FURTHER READING
11 Podiatric management of the elderly
CHAPTER CONTENTS
KEYWORDS
INTRODUCTION
NAIL CONDITIONS AND CARE
RISK FACTORS ASSOCIATED WITH THE DEVELOPMENT OF ULCERATION IN THE FEET AND LEGS
Health professionals involved in multidisciplinary care
Dietician
District nurse
Vascular specialist
MUSCULOSKELETAL CHANGES
Muscle tissue
Tendon and ligament
Management of change
FALLS IN OLDER PEOPLE
Risk factors associated with falls
What is the ideal footwear style for an older person?
POLYPHARMACY
Long-term disease and older people
QUALITY OF LIFE
DUTY OF CARE
Hypothermia risk
Dehydration
Dementia and depression
Osteoporosis and fracture
Incontinence
Malnutrition
CONCLUSION
ACKNOWLEDGEMENT
REFERENCES
FURTHER READING
12 Paediatric podiatry and genetics
CHAPTER CONTENTS
KEYWORDS
NORMAL GROWTH AND DEVELOPMENT
Knock-knee, bow leg and rickets
Rickets
Flat foot
Peak rates of growth
FOOTWEAR
Inadequate footwear
Plimsolls
Babywalkers
Fashion, peer-group pressure and economics
Trainers
FOOT TYPE
Low-arched and high-arched feet
INFECTIONS
Onychocryptosis (ingrowing toenail)
ANATOMICAL ANOMALIES
Sesamoid bones
Supernumerary bones
Tarsal coalition (peroneal spastic flat foot)
BIOMECHANICAL ANOMALIES/ABNORMALITIES
Acquired deformity
Mucopolysaccharidosis
Juvenile hallux abducto valgus
INJURIES
Juvenile hallux rigidus
CONGENITAL ABNORMALITIES
BASIC PRINCIPLES OF HUMAN GENETICS
GENETIC AND CONGENITAL DISORDERS
Chromosome abnormalities
Single-gene disorders
Multifactorial disorders
SYNDROMES
The lower limbs
Polydactyly
Syndactyly (webbed toes - zygodactyly)
ASSESSMENT OF A FAMILY WITH A GENETIC DISORDER
Drawing the family tree
Interpreting the family tree
OLIGODACTYLY
CONGENITAL OVERLAPPING FIFTH TOE (DIGITI MINIMI QUINTI VARUS)
CURLY TOES
CONGENITAL FLEXED TOE
METATARSUS ADDUCTUS
HALLUX VARUS
CONGENITAL TALIPES EQUINOVARUS: CLUBFOOT
TALIPES CALCANEOVALGUS
VERTICAL TALUS (ROCKER BOTTOM FOOT)
ONYCHOGRYPHOSIS
ARTHROGRYPOSIS MULTIPLEX CONGENITA
CONGENITAL CONSTRICTION BAND SYNDROME
POSTURAL ANOMALIES/ABNORMALITIES
SURGICAL/MEDICAL CONDITIONS
Leg-length discrepancy
Linear scleroderma
Localised scleroderma (morphea)
Pes cavus
Sever's disease (calcaneal apophysitis)
Kohler's disease of the navicular
Freiberg's disease
Stress fracture of a metatarsal (march or fatigue fracture)
Diabetes
Poliomyelitis
Spina bifida cystica
Cerebral palsy
Muscular dystrophies
Duchenne muscular dystrophy
Hypermobility syndrome
Ehlers-Danlos syndrome
Limb pain of childhood with no organic disease
Juvenile idiopathic arthritis (juvenile chronic arthritis)
Psoriatic arthritis
Raynaud's phenomenon
Haemophilia
Turner's syndrome
Down's syndrome (trisomy 21)
Tuberous sclerosis
DERMATOLOGICAL CONDITIONS
EXAMINATION AND ASSESSMENT
Observe gait and posture with footwear
Subjective questioning of child and/or parent
Measure feet, measure footwear
Examine footwear
Visual examination of foot for skin, nail, soft-tissue and bony lesions
Physical examination of lesions as required
Physical examination of range, quality and direction of motion in all joints of the foot
Biomechanical assessment, including examination for forefoot/rearfoot malalignment
Observe and assess barefooted gait and general posture
Comparison
Diagnosis
Produce a management plan
Written information
MANAGEMENT
Footwear advice and prescription
Passive and active exercises
Orthoses for passive and dynamic use
Night splints
Silicone
Casted foot orthoses
THE ROLE OF THE PAEDIATRIC PODIATRIST
REFERENCES
FURTHER READING
13 Sports medicine and injuries
CHAPTER CONTENTS
KEYWORDS
INTRODUCTION
ATHLETIC PROFILE AND HISTORY TAKING
Past treatment history
CHRONIC OR OVERUSE INJURIES
Physical factors
Psychological factors
Patient constraints
RUNNING
The four phases of running
The walking-running cycle
Marathon running
CHILD AND ADOLESCENT SPORTS
FOOTBALL - SOCCER
GYMNASTICS
BASKETBALL
BOWLING
TENNIS
GOLF
AMERICAN FOOTBALL
RUGBY
STEP/BENCH AEROBICS
BALLET AND DANCE
Tendinitis
Posterior and anterior impingement syndrome of the ankle
Shin splints
Ankle sprains and toe sprains
Stress fractures
Hallux limitus
Bunion deformities
Neuromas
Nail problems
BASEBALL
SKIING
Cross-country skiing
SNOWBOARDING
FOREFOOT INJURIES
Metatarsalgia
Capsulitis
Bursa formation and bursitis
Sesamoiditis and fracture
Metatarsal stress fractures
Osteochondritis dissicans - Freiberg's infraction
Morton's neuroma
Hallux limitus and rigidus
Bunion deformity in the athlete
Tailor's bunion
REARFOOT INJURIES
Infracalcaneal heel pain
Ankle equinus
Achilles tendon injuries
Partial rupture of the Achilles tendon
Acute complete rupture of the Achilles tendon
Insertional Achilles tendinitis and calcific tendinosis
Retrocalcaneal exostosis (Haglund's deformity)
ANKLE INJURIES
Anatomy
LEG INJURIES
Chronic leg pain in the athlete
Tibial fasciitis - shin splints
Treatment
Stress fracture of the tibia and fibula
Acute and chronic compartment syndrome
Anatomy
Muscle soreness
Muscle cramps
Muscle herniations
Posterior tibial tendon dysfunction in the athlete
Anatomy
Aetiology
History, physical examination and clinical findings
Fibular (peroneal) tendinitis and tenosynovitis
Subluxing fibularis (peroneus) tendons
Overuse knee injuries
Definition
Symptoms
Signs
Treatment
Biomechanical causes of knee injuries
The patellofemoral joint
Patellofemoral problems in runners
Chondromalacia patellae
Knee plica
Iliotibial band friction syndrome
Popliteus tendinitis
Hamstring tendinitis
Groin injury/strain
LEG-LENGTH DISCREPANCY
THE FEMALE ATHLETE TRIAD
SPORTS SHOES
Shoe manufacture
Lasts
Shape of the last
Other factors
The heel counter
The tongue
Insole
Outsole
Midsole
Upper
Scientific evaluation
Features of a good sports shoe
REFERENCES
14 Basic biomechanics of gait
CHAPTER CONTENTS
KEYWORDS
INTRODUCTION
CONTACT FORCES AND ATTRACTION FORCES
Mass and weight
Units of force
Scalars and vectors
CENTRE OF GRAVITY
MUSCULOSKELETAL SYSTEM FUNCTION
STABILITY
CENTRE OF PRESSURE
LOAD, STRAIN, AND STRESS
Tension stress
Compression stress
Shear stress
GAIT CYCLE
Trajectory of the centre of gravity
Ground reaction force
Components of the ground reaction force
Path of the centre of pressure
GAIT ANALYSIS
Diagnosis of gait disorders
Qualitative gait analysis
Quantitative gait analysis
REFERENCES
15 Structure and function of the foot
CHAPTER CONTENTS
KEYWORDS
INTRODUCTION
SKELETON OF THE FOOT
MOVEMENTS OF THE ANKLE AND FOOT
Ankle joint
Subtalar joint
Pronation and supination
ARCHES OF THE FEET
Passive arch support
Active arch support
Interaction of the arch support mechanisms
THE WINDLASS MECHANISM OF THE FOOT
STRUCTURAL ADAPTATION OF THE MUSCULOSKELETAL SYSTEM
Structural adaptation in bone
The chondral modelling phenomenon
Modelling of metaphyses and epiphyses
Modelling of articular surfaces
REFERENCES
16 Clinical therapeutics
CHAPTER CONTENTS
KEYWORDS
THE THERAPEUTIC MANAGEMENT OF SUPERFICIAL LESIONS
Operating
Medicaments
Dressings
Padding and strapping
Review periods
Case records
CONTROL AND TREATMENT OF THE HYPERKERATOSES
Pathological callus
Postoperative antisepsis
Emollients
Astringents
Silicone implants
Heloma durum (hard corn) of the digits
Heloma durum (hard corns) on the plantar metatarsal area
Interdigital heloma
Vascular and neurovascular heloma
Heloma miliare (seed corns)
Palmoplantar hyperkeratosis
SHORT-TERM PADDING THERAPY
Digital padding for the lesser toes
Plantar metatarsal padding
THE TREATMENT OF VERRUCA PEDIS
The treatment of verrucae
Chemical cautery
Disadvantages of treatment with chemical therapy
Therapeutic agents for chemical cautery
Salicylic acid
Monochloroacetic acid
Trichloroacetic acid
Potassium hydroxide
Single-treatment techniques
Cryotherapy
Electrosurgery and radiosurgery using cutting, coagulation, desiccation and fulguration
Background
Electrosurgical physics
Equipment
Safety
Patient selection
Procedures
Electrosurgical treatment of verrucae
Nail bed ablation
Suggested procedure for desiccation of heloma durum (hard corn)
INFLAMMATORY CONDITIONS
Perniosis (erythema pernio, chilblains)
Ulceration
TREATMENT OF DISORDERS OF THE SWEAT GLANDS
Hyperhidrosis
Anhidrosis
TREATMENT OF FUNGAL INFECTIONS
Tinea pedis
Clinical features of tinea pedis
Treatment
Undecenoic acid
Tolnaftate
The imidazoles
Tea tree oil
Tinea unguium (onychomycosis)
Clinical features of tinea unguium
Candidosis
PHYSICAL THERAPY
Heat and cold
Heat
Physiological effects
Increased blood supply
Generalised effects of heating
Heat therapy
Infrared radiation
Ultrasound
Cold
Cryotherapy/cold therapy
Ice packs
Cold sprays
FOOTBATHS
Methods of application
Cold footbaths
Contrast footbaths
Warm water footbaths
Hypertonic footbaths
Antiseptic astringent footbaths
LASERS
Properties of laser light
The effect of laser light
Safety
Treatment technique
Contraindications
Laser in patient management
MAGNETOPULSE
Contraindications
Operation of magnetopulse equipment
Method: machine with two pads
Method: machine with four pads
Indications
NON-THERMAL ELECTROTHERAPY
Faradism - muscle stimulation
Technique
Electrodes
Interferential
Relief of pain
Motor stimulation
Technique
Contraindications
ACUTE AND CHRONIC INFLAMMATORY CONDITIONS
Tension strappings
Medial support
Lateral support
Neutral support
Valgus padding
Applications
Tarsal platform (filler pad)
Applications
Tarsal cradle
Padding and strapping for hallux abducto valgus
Padding and strapping for hallux limitus/rigidus
Plantar digital neuritis
Plantar fasciitis
Method
March fracture
Freiberg's infarction
REFERENCES
FURTHER READING
17 Orthoses
CHAPTER CONTENTS
KEYWORDS
PRINCIPLES OF MANAGEMENT
REPLACEABLE PADS
ELASTIC ANKLETS AND BRACELETS
INSOLES
Non-casted insoles
Casted insoles
FUNCTIONAL ORTHOSES
The Root paradigm
The sagittal plane paradigm
The proprioceptive, preferred- motion-pathway paradigm
The tissue-stress paradigm
Paradigms in practice: reconciling the controversy of foot function paradigms
Material choice and casting techniques
Custom versus prefabricated orthoses
CAD-CAM orthoses
Prescription writing for CAD-CAM direct-milled orthoses
Types of orthosis
Prescription variations
Flexibility
Heel-cup height
Width
Postings
Accommodations
Problem solving
Devices do not fit shoes
Devices cut into the lateral side of the heel
First metatarsal irritation
Devices are too tight at the heel
Irritation in the area of the medial longitudinal arch
Insufficient control
EEC DIRECTIVE ON THE MANUFACTURE OF ORTHOSES
SILIPOS
HEEL ORTHOSES
LATEX TECHNIQUE
DIGITAL APPLIANCES FOR THE LESSER TOES
SILICONES
THERMOPLASTICS
Hot-water plastics (Polyform, Aquaplast Hexcelite, X-Lite Plus)
Low-temperature moulding
Chairside technique
Rapid remoulding
No waste
Complex construction
Hexcelite (X-Lite Plus)
CONCLUSION
REFERENCES
18 Footwear
CHAPTER CONTENTS
KEYWORDS
INTRODUCTION
FUNCTION OF FOOTWEAR
Primary function
Secondary functions
Completing a fashion
Conducting specific tasks
Compensating for an abnormality
PARTS OF A SHOE
The upper
The toe box
The toe cap
The vamp
The tongue
The quarters
The sole
The insole
Bottom fillings
The welt
The outsole
The subsidiary parts
The heel
The shank
The counter
The backstay
FEATURES OF A GOOD-FITTING SHOE
Good retaining medium
Close-fitting medial and lateral quarters
Adequate width and depth in the toe box
Correct length
Correct width fitting
Adequate heel seat
Heel height no greater than 2 inches (5 cm)
Broad heel base in contact with the ground
Upper material made of leather or other natural material
FOOTWEAR AND LAST TERMINOLOGY
Tread line
Toe spring
Rigidity of the outsole
Style of shoe
Heel height
Heel pitch
Flare
DESIRABLE FEATURES OF FOOTWEAR FOR SPECIFIC FOOT CONDITIONS
Hallux abducto valgus
Hallux limitus/rigidus
The short, broad foot
The long, mobile foot
The highly arched foot
The foot of the patient with rheumatoid arthritis
The foot of the patient with diabetes
SIZE SYSTEMS AND SYSTEMS OF MEASUREMENT
The English size system
The Continental size system
COMMON FOOTWEAR STYLES
Tie lace
The Oxford shoe
The Derby shoe
The moccasin-style shoe
The sandal
The court shoe
Sports shoes
Boots
WEAR MARKS AS AN AID TO DIAGNOSIS
Normal wear
The outsole and heel
The insole (sock lining)
The lining of the upper
The upper
Wear marks seen in association with common foot disorders
Hallux limitus/rigidus
The outsole and heel
The insole (sock lining)
The lining of the upper
The upper
Pes cavus
The outsole and heel
The insole (sock lining)
The lining of the upper
The upper
Pes plano valgus
The outsole and heel
The insole (sock lining)
The lining of the upper
The upper
THERAPEUTIC FOOTWEAR
Introduction
Indications for therapeutic footwear
CLASSES OF THERAPEUTIC FOOTWEAR
Stock surgical footwear
Modular and bespoke footwear
Features of the therapeutic shoe upper
Features of soling in therapeutic footwear
HEELS
Heel height
HEEL MODIFICATIONS
Thomas heel
Flared heels (floats)
Combined heel and sole modifications
Flares (floats)
Wedges
Contralateral wedging
Through-sole and heel wedging
MODIFICATIONS TO THE SOLE
Lateral sole wedges
Medial toe wedges
Bars
Rocker soles
Adding rockers to existing footwear
Shoe raises
Measuring for the raise
Types of raise
ASSESSING THE FIT OF THERAPEUTIC FOOTWEAR
CONCLUSION
REFERENCES
FURTHER READING
19 Pain control
CHAPTER CONTENTS
KEYWORDS
DEFINITION
ANATOMY
SOMATIC PAIN
PHYSIOLOGY
Peripheral nociceptor level
Spinal level
Supraspinal level
Neuropathic pain
PRINCIPLES OF PAIN MANAGEMENT
THE WORLD HEALTH ORGANIZATION (WHO) THREE-STEP ANALGESIC LADDER
Step 1
Step 2
Step 2 to 3
Step 3
ADJUVANT ANALGESICS
ANTIDEPRESSANTS
ANTICONVULSANTS
ANTIARRHYTHMICS
TOPICAL DRUGS
NMDA RECEPTOR ANTAGONISTS
REGIONAL ANALGESIA
PHYSICAL THERAPY
PSYCHOLOGY
SPECIFIC CHRONIC PAIN CONDITIONS OF THE LOWER LIMB
Complex regional pain syndrome
REFERENCES
FURTHER READING
20 Local anaesthesia
CHAPTER CONTENTS
KEYWORDS
INTRODUCTION AND BACKGROUND
BASIC CHEMISTRY AND PHARMACOLOGY
Membrane electrophysiology
CHOICE OF LOCAL ANAESTHETIC AND DOSAGE
Bupivacaine
Levobupivacaine
Etidocaine
Lidocaine
Mepivacaine
Prilocaine
Ropivacaine
LOCAL AND SYSTEMIC COMPLICATIONS AND TOXICITY
Local effects
Systemic effects
Central nervous system (CNS)
Cardiovascular system
Allergic reaction
Hepatic and renal function
Pregnancy
Drug interactions
LOCAL ANAESTHETICS IN PRACTICE
SPECIFIC SITES
Local infiltration
The digital block
The ray block
Posterior tibial nerve
The sural nerve (root index S1/S2)
Saphenous nerve (root index L3/L4)
The superficial peroneal (fibular) nerves (root index L4/L5, S1)
The deep peroneal (fibular) nerve (root index L4/L5, S1/S2)
The popliteal block
REFERENCES
FURTHER READING
21 Nail surgery
CHAPTER CONTENTS
KEYWORDS
PHENOLISATION
Phenol
History
THE PHENOLISATION TECHNIQUE
Total nail avulsion
Partial nail avulsion
Postoperative management
SURGICAL PROCEDURES
Winograd procedure
Zadik's procedure
Frost procedure
Terminal Syme's amputation
AVULSION USING UREA
TREATMENT OF SUBUNGUAL EXOSTOSIS
REFERENCES
22 Diagnostic imaging
CHAPTER CONTENTS
KEYWORDS
INTRODUCTION
IMAGING MODALITIES
MAGNETIC RESONANCE IMAGING
ULTRASOUND
IMAGING MODALITIES UTILISING IONISING RADIATION: SAFETY AND LEGISLATION
COMPUTERISED TOMOGRAPHY
FLUOROSCOPY
NUCLEAR MEDICINE IMAGING
PLAIN RADIOGRAPHY
COMMON RADIOGRAPHIC PROJECTIONS
The dorsoplantar projection (also known as the anteroposterior view)
Lateromedial oblique projection
Mediolateral oblique projection
Lateral projections
Digital projections
Sesamoid positioning
Tarsal and ankle projections
RADIOGRAPHIC CHARTING
RADIOGRAPHIC ASSESSMENT AND INTERPRETATION
DEVELOPMENTAL VARIANTS: NORMAL AND ABNORMAL
OSTEOCHONDRITIS OR OSTEONECROSIS?
BONE TUMOURS
BONES, JOINTS AND CONNECTIVE TISSUES
FRACTURES
REFERENCES
23 Podiatric surgery
CHAPTER CONTENTS
KEYWORDS
INTRODUCTION
PATIENT SELECTION FOR SURGERY
PATIENT CONSENT
DIGITAL DEFORMITIES
Flexor stabilisation
Flexor substitution
Extensor substitution
Adducto varus deformity
Mallet toe
Surgical treatment
Excisional arthroplasty
Arthrodesis
Digital amputation
HALLUX VALGUS
Procedures
Simple bunionectomy
Distal metaphyseal procedures
Midshaft procedures
Basal procedures
Hallux procedures
Evaluation
HALLUX VALGUS SYNDROME
MORTON'S NEUROMA
LESSER METATARSAL OSTEOTOMIES
HALLUX RIGIDUS
SESAMOID PROBLEMS
SKIN PLASTIES
REARFOOT SURGERY
SUTURE MATERIALS
SUTURE TECHNIQUES
Simple interrupted sutures
Mattress sutures
Cross-over sutures
Continuous sutures
TISSUE HANDLING
POSTOPERATIVE DRESSINGS
The inner or contact layer
The middle layer
The outer layer
The surface layer
When to re-dress
POSTOPERATIVE COMPLICATIONS
Infection
Swelling
Dehiscence
Haematoma
Joint stiffness
Hypertrophic scarring
Transfer metatarsalgia
Avascular necrosis
Chronic regional pain syndrome
REFERENCES
24 Principles of infection control
CHAPTER CONTENTS
KEYWORDS
INFECTION TERMINOLOGY
Pathogen
Infection
Infective dose
Colonisation
Carriers
Sources of infection
Vehicles of infection
Cross-infection
Portals of entry
Portals of exit
Normal flora of the body
CHIEF SOURCES AND RESERVOIRS OF INFECTION
Endogenous sources
Exogenous sources
Infected or colonised people
Infected or colonised animals
Environmental sources and reservoirs
TRANSMISSION OF INFECTION
Direct transmission
Indirect transmission routes
Transmission by clinical items
Airborne transmission
Transmission by animals
Faecal transmission
HEPATITIS B VIRUS (HBV), HEPATITIS C VIRUS (HCV) AND HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTIONS
Hepatitis B and hepatitis C viruses (HBV and HCV)
HIV and AIDS
Implications for podiatrists
VARIANT CREUTZFELDT-JAKOB DISEASE
INFECTION CONTROL
Terminology
Sterilisation
Disinfection
Antisepsis
Asepsis
STRATEGIES AND METHODS OF CONTROL
Elimination of sources and reservoirs
Disruption of transmission routes
Cleaning
Disinfection
Disinfection by hot water
Disinfection by chemicals
Types of chemical disinfectant
Phenolic compounds
Chlorine compounds
Iodine compounds
Alcohols
Biguanide compounds
Triclosan (2,4,4´-trichloro-2´-hydroxydiphenylether)
Quaternary ammonium compounds
Glutaraldehyde
Hexachlorophane
Disinfection of specific items
Skin disinfection
Hands
Patients' skin
Sterilisation
Steam at increased pressure
Dry heat
Glass bead sterilisers
FURTHER MICROBIOLOGICAL ASPECTS OF CLINICAL WORK
Protective clothing
Aseptic technique
Sterile fields
Dressing changes
Waste disposal
Operating rooms
Laboratory specimens
INFECTION-CONTROL POLICIES
REFERENCES
FURTHER READING
25 Medical emergencies in podiatry
CHAPTER CONTENTS
KEY WORDS
CLINICAL ASSESSMENT
CLINICAL MONITORING
EMERGENCY DRUGS AND EQUIPMENT
PREDICTABLE EVENTS
Cardiovascular: angina (ischaemic heart disease)/myocardial infarction
Hypertension
Dysrhythmia
Heart valves/stents
Respiratory
Asthma
Chronic obstructive pulmonary disease
Endocrine
Diabetes
Hypoglycaemia
Hyperglycaemia
Hepatic/renal
Renal failure
Hepatic disease
Central nervous system
Transient ischaemic attack/stroke
Epilepsy
Minor fits
Major fits
UNPREDICTABLE EVENTS
Vasovagal syncope
Cardiac arrest
Allergy/anaphylaxis
Local anaesthetic toxicity
SUMMARY
FURTHER READING
26 Evolution and its influence on human foot function
CHAPTER CONTENTS
KEY WORDS
INTRODUCTION
SOME LARGE-SCALE DIFFERENCES BETWEEN THE HOMINOIDEA
A comparison of gait cycles
The functional adaptation of the midtarsal joint and the medial and lateral columns
The functional transformation of the subtalar joint
Orientation of the medial metatarsal-cuneiform joint
Relative robusticity of the metatarsals
Torsion of the metatarsal shafts
Morphology of the metatarsal heads
EVOLUTIONARY BASIS FOR SOME CLINICAL DISORDERS OF THE HUMAN FOOT
REFERENCES
27 Health promotion and patient education
CHAPTER CONTENTS
KEYWORDS
INTRODUCTION
THE PODIATRIST'S ROLE AS A HEALTH PROMOTER/EDUCATOR
PATIENT EDUCATION
EVIDENCE-BASED PRACTICE
CONCLUSIONS
REFERENCES
28 Clinical governance
CHAPTER CONTENTS
KEYWORDS
INTRODUCTION
CHRONOLOGY
BACKGROUND
ASPECTS
Quality planning
Workforce planning and developing the workforce
Information technology
Research
Poor performance
Learning from experience
Risk management
Consent and informed consent
REFERENCES
29 Health and safety in podiatric practice
CHAPTER CONTENTS
KEYWORDS
INTRODUCTION
EFFECTIVE MANAGEMENT
SUCCESSFUL HEALTH AND SAFETY MANAGEMENT
SAFETY CULTURE
SAFE SYSTEMS OF WORK
LEGAL DUTIES
THE EMPLOYER'S RESPONSIBILITY TO VARIOUS PARTIES
Employees
Responsibilities of employees
Trainees (i.e. student podiatrists on work experience or a placement)
Health surveillance
Visitors and the general public
Trespassers
HEALTH AND SAFETY POLICY
General statement of intent
Health and safety at work responsibilities
Administration of health and safety at work
RISK ASSESSMENTS
Record-keeping requirements
Safe systems of work
Accident procedures
Working environment
Control of chemicals
Fire safety
Physical agents/stored energy
Plant and equipment
Handling operations
Risk assessment
Principles of risk assessment
Problem-solving and decision-making
Evaluation and expression of risk
Residual risk
Expressions to identify risk
Principles for risk control
Basis for assessment
Five steps to risk assessment
Step 1. Look for hazards
Step 2. Decide who might be harmed, and how
Step 3. Evaluate the risks from the hazards and decide whether existing precautions are adequate or whether more is required
Step 4. Record findings
Step 5. Review assessments on a regular basis and revise when necessary
Using risk factors to evaluate risk
Likelihood of occurrence rating
Expressing priorities for risk control
Limits of reasonable practicability
So far as is practicable
Refinement of risk factors to help apply control principles
Checklist for risk assessments
Generic risk assessments
LEGAL REQUIREMENTS WHERE RISK ASSESSMENT IS SPECIFIED - SPECIFIC RISKS
Noise at Work Regulations 2005
Health and Safety (Display Screen Equipment) Regulations 1992 (as amended 2002)
Manual Handling Operations Regulations 1992 (as amended 2002)
Personal Protective Equipment at Work Regulations 1992 (as amended 2005)
Control of Substances Hazardous to Health Regulations 2002
Management of Health and Safety at Work (Amendment) Regulations 1999
The Regulatory Reform (Fire Safety) Order 2005
Health and Safety (First Aid) Regulations 1981
REFERENCES
Index
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z
Inside Back Cover

Systemvoraussetzungen

Dateiformat: ePUB
Kopierschutz: Adobe-DRM (Digital Rights Management)

Systemvoraussetzungen:

Computer (Windows; MacOS X; Linux): Installieren Sie bereits vor dem Download die kostenlose Software Adobe Digital Editions (siehe E-Book Hilfe).
Tablet/Smartphone (Android; iOS): Installieren Sie bereits vor dem Download die kostenlose App Adobe Digital Editions oder die App PocketBook (siehe E-Book Hilfe).
E-Book-Reader: Bookeen, Kobo, Pocketbook, Sony, Tolino u.v.a.m. (nicht Kindle)

Das Dateiformat ePUB ist sehr gut für Romane und Sachbücher geeignet – also für „fließenden” Text ohne komplexes Layout. Bei E-Readern oder Smartphones passt sich der Zeilen- und Seitenumbruch automatisch den kleinen Displays an.
Mit Adobe-DRM wird hier ein „harter” Kopierschutz verwendet. Wenn die notwendigen Voraussetzungen nicht vorliegen, können Sie das E-Book leider nicht öffnen. Daher müssen Sie bereits vor dem Download Ihre Lese-Hardware vorbereiten.

Bitte beachten Sie: Wir empfehlen Ihnen unbedingt nach Installation der Lese-Software diese mit Ihrer persönlichen Adobe-ID zu autorisieren!

Weitere Informationen finden Sie in unserer E-Book Hilfe.

Dateiformat: PDF
Kopierschutz: Adobe-DRM (Digital Rights Management)

Systemvoraussetzungen:

Computer (Windows; MacOS X; Linux): Installieren Sie bereits vor dem Download die kostenlose Software Adobe Digital Editions (siehe E-Book Hilfe).
Tablet/Smartphone (Android; iOS): Installieren Sie bereits vor dem Download die kostenlose App Adobe Digital Editions oder die App PocketBook (siehe E-Book Hilfe).
E-Book-Reader: Bookeen, Kobo, Pocketbook, Sony, Tolino u.v.a.m. (nicht Kindle)

Das Dateiformat PDF zeigt auf jeder Hardware eine Buchseite stets identisch an. Daher ist eine PDF auch für ein komplexes Layout geeignet, wie es bei Lehr- und Fachbüchern verwendet wird (Bilder, Tabellen, Spalten, Fußnoten). Bei kleinen Displays von E-Readern oder Smartphones sind PDF leider eher nervig, weil zu viel Scrollen notwendig ist.
Mit Adobe-DRM wird hier ein „harter” Kopierschutz verwendet. Wenn die notwendigen Voraussetzungen nicht vorliegen, können Sie das E-Book leider nicht öffnen. Daher müssen Sie bereits vor dem Download Ihre Lese-Hardware vorbereiten.

Bitte beachten Sie: Wir empfehlen Ihnen unbedingt nach Installation der Lese-Software diese mit Ihrer persönlichen Adobe-ID zu autorisieren!

Weitere Informationen finden Sie in unserer E-Book Hilfe.

Dateiformat: ePUB
Kopierschutz: Wasserzeichen-DRM (Digital Rights Management)

Systemvoraussetzungen:

Computer (Windows; MacOS X; Linux): Verwenden Sie eine Lese-Software, die das Dateiformat ePUB verarbeiten kann: z.B. Adobe Digital Editions oder FBReader – beide kostenlos (siehe E-Book Hilfe).
Tablet/Smartphone (Android; iOS): Installieren Sie die App Adobe Digital Editions oder eine andere Leseapp für E-Books, z.B. PocketBook (siehe E-Book Hilfe).
E-Book-Reader: Bookeen, Kobo, Pocketbook, Sony, Tolino u.v.a.m.

Das Dateiformat ePUB ist sehr gut für Romane und Sachbücher geeignet - also für „fließenden” Text ohne komplexes Layout. Bei E-Readern oder Smartphones passt sich der Zeilen- und Seitenumbruch automatisch den kleinen Displays an.
Mit Wasserzeichen-DRM wird hier ein „weicher” Kopierschutz verwendet. Daher ist technisch zwar alles möglich – sogar eine unzulässige Weitergabe. Aber an sichtbaren und unsichtbaren Stellen wird der Käufer des E-Books als Wasserzeichen hinterlegt, sodass im Falle eines Missbrauchs die Spur zurückverfolgt werden kann.

Weitere Informationen finden Sie in unserer E-Book Hilfe.

Als PDF speichern Als Link merken