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FOOT, AND ANKLE An overview of how and why injuries occur, how to help prevent them, and how to treat them. By Mattie Weber MECHANISM OF INJURY (HOW IT HAPPENED, OR WHY IT HAPPENED) An injury is either functional or structural An injury can be caused by tension (stretching), compression, shearing, or bending STRUCTURAL A structural injury is caused by excessive stress on the bone, by lengthened or shortened tissue, or overuse of a muscle/ tissue EXAMPLES OF A STRUCTURAL INJURY Claw Toes Hammer Toes Damage to the Accesory Navicular Morton’s Neuroma Hallux Valgus CLAW TOES This happens when flexor digitorum brevis ( a muscle that connects to the middle phalanx of the toes) over powers the rest of the 5 foot muscles. This causes extension of the middle phalanx, and flexion of the proximal phalanx/ Distal interphalangeal joint HAMMER TOES A hammer toe is a toe that is flexed at the proximal interphalangeal joint, and extenstion of the metatarsophalangeal joint There are 2 classifications of hammer toes: flexible and rigid Flexible hammer toes are moveable, and can be straightened manually Rigid hammer toes doesn’t have this ability; movement can be very painful MORTON’S NEUROMA This is an enlarged nerve that runs between the 1st and 2nd metatarsals, and the 3rd and 4th metatarsals HALLUX VALGUS This is commonly associated with bunions Normally occurs in the first metatarsal (big toe) when it deviates inward FUNCTIONAL These injuries can be pre-disposed There are two stages: acute and chronic This could be related to the structure of the injured area Fractures are the main type of Functional injuries FRACTURES In a fracture, a bone is either cracked or broken Many types of Fractures– simple, transverse, oblique, spiral, comminuted, segmental, avulsed, and impacted The only treatment for these injuries is immoblization of the area and rest http://www.youtube.com/watch?v=kbvx5DYS6tE http://www.youtube.com/watch?v=DS8AdZNlKoI http://www.youtube.com/watch?v=wcqVloclNNI SIMPLE FRACTURE A simple fracture is one that doesn’t break the skin; also known as a closed fracture. There may be bruising and swelling, but no obvious signs of a fracture TRANSVERSE FRACTURE A fracture that occurs straight across the bone OBLIQUE FRACTURE Broken at an angle across the bone Usually a result of a sharp, angled blow to the area SPIRAL FRACTURE A fracture where the bone has been twisted apart Also known as a “torsion fracture” Can happen when a foot is planted, and the leg twists COMMINUTED FRACTURE A fracture where the bone is completely crushed This is a very hard thing to correct, because the bone is in many pieces SEGMENTAL FRACTURE A fracture where the bone is in many different pieces There are multiple fractures on the same bone AVULSED FRACTURE An injury to the bone where a ligament or tendon attaches When this occurs, the ligament or tendon pulls of a piece of the bone, resulting in a fracture. IMPACTED FRACTURE Also known as a “greenstick fracture” The bone “splinters” like a young green limb from a tree or bush It doesn’t completely break STRESS FRACTURES These occur from over use of a bone Most common in repetative motion sports (running, soccer, softball, baseball, etc) Occurs where the bone changes density or shape The only way to treat this is rest and immoblization ANKLE SPRAINS