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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