Surgery 1- 5th Met Deformities (2-08-08)(5)

Surgery 1- 5th Met Deformities (2-08-08)(5) - Surgery...

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Surgery 2-08-08: 5 th Met Deformities Appleton Page | 1 ‘Tailor’s Bunion’ Dr. Trepal Entity - series of symptoms or deformities involving the 5 th ray and 5 th MTPJ - Frequently Referred to as: o ‘Tailor’s Bunion’, Bunionette, Plantarflexed 5 th Metatarsal, Exostosis, associated with Splayfoot, and Digiti Quinti Varus - A condition involving a frequent adductovarus, osseous prominence on met head (either lateral or dorsal lateral, plantar), interacts with shoe- causing erythema, hyperkaratosis, bursitis - Frequently associated with a wide foot (Splay foot) o Tailors bunion and regular bunions (hallux valgus) frequently occur in same foot - Lesion can occur plantar or plantar-lateral o Can be from functional problem and biomechanics of the foot Epidemiology - True prevalence is unknown - Female to male ratio = 1-10:1 (more common in females, more closely 10:1) Etiology - shoe irritation against an osseous prominence - A tight shoe will cause more irritation - In a narrow tip shoe the point where the irritation will be in medial to the first metatarsal and lateral to the 5 th metatarsal - Standing barefoot allows splaying of foot, and put in shoe and gets compressed Ex) put 5 cars into a parking space for 4 – something will give Barefoot Foot in Shoe
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Surgery 2-08-08: 5 th Met Deformities Appleton Page | 2 Etiology: Structural True exostosis or bump on the bone Aplastic or hypertrophic tissue Everything else is normal alignment except for met head Widening or migration of the space between the 4 th and 5 th met See an increase in the inter-metatarsal angle This occurs due to movement or migration of the metatarsal Not an exostosis or enlargement of the met head, but a mal- position= splayfoot Lateral Bowing or deviation of the 5 th metatarsal Varus deformity of the forefoot- forefoot is inverted to the rearfoot When patient walks the lateral border hits the ground first Symptoms develop plantar lateral Cavus or plantarflexed metatarsals High arched foot Results in increased weight bearing on the metatarsal heads Adductus deformity Deformity in the transverse plane C-shaped foot Metatarsus adductus Pressure and irritation along lateral border - Not all talor’s bunions are the same - Key thing about surgery is that the actual skills are understanding how to diagnose and choosing necessary operation for the condition
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Surgery 2-08-08: 5 th Met Deformities Appleton Page | 3 Etiology: Functional Biomechanical condition that leads to hyperpronation of the foot or varus influence coming from the hind foot and influencing the forefoot Lateral border will take the impact and create the symptoms of talors bunion
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This note was uploaded on 05/29/2011 for the course SURGERY 101 taught by Professor Dunno during the Spring '11 term at New York College of Podiatric Medicine.

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Surgery 1- 5th Met Deformities (2-08-08)(5) - Surgery...

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