Ankle and foot deformity

1.Hallux valgus
A.病因：

• M1M2IM>10
• 1st MTP>20

B.治療

• Distal Chevron(Mitchell) osteotomy(best way)
• Proximal osteotomy+distal soft tissue procudure
• Keller procedure
• Akin procedure
• Scarf osteotomy

2.Hallux rigidus

病因：

• metatarsal head 有osteophyte
• rigidus

治療

• 無arthritis→chielectimy
• 有arthritis→osteotomy or arthrodesis

3.ankle arthritis

病因：

• ankle instability
• AVN of talus
• inflammatory arthritis
• RA
• degenerative arthritis
• traumatic arthritis(最常見)

治療

• shoe insert
• chielectomy
• lower tibia osteotomy
• high tibia osteotomy(不好用)
• total ankle replacement(成效不彰)→用於RA
• ankle arthrodesis
• triple arthrodesis

4.Flat foot

病因：

• hypermobile flatfoot
• adult flatfoot
• acquired flatfoot

分期

• stage1
• stage2
• stage3
• stage4

治療

• tendon transfer
• calcaneal osteotomy
• isolated talonavicular arthrodes
• double arthrodesis
• triple arthrodesis

5.charcot foot

病因：

• DM併發症

分期

• stage1→急性發炎
• stage2→骨頭healing
• stage3→手術在這期執行

治療

6.plantar fasiitis

支持性治療(80%會好)

• NSAID
• shoe inset and heel cup
• achillis and plantar fascia stretch

手術治療

• total or subtotal faciotomy
• extracorporeal shock wave therapy

7.heel pain-haglund's