Foot

The bones of the feet are divided into three parts: the hindfoot, midfoot, and forefoot. Seven bones called tarsals make up the hindfoot and midfoot. The calcaneus (heel bone) is the largest of the tarsal bones in the back of the foot (hindfoot). The talus sits above the calcaneus and connects the foot and leg. The talus and calcaneusform the subtalar joint, which allows side-to-side movement of the hindfoot.

The midfoot is the middle region of the foot, where a cluster of small bones forms an arch on the top of the foot. From this cluster, five long bones (metatarsals) extend to the toes. The bones are held in place by connective tissues (ligaments) that stretch both across and down the foot.The midfoot is critical in stabilizing the arch and in walking. During walking, the midfoot transfers the forces generated by the calf muscles to the front of the foot.

The forefoot has five metatarsal bones and 14 phalanges (toe bones). There are three phalanges in each toe—except for the first toe, which usually has only two.All the bones in the forefoot work together when walking. A fracture, or break, in any of these bones can be painful and impact foot function.

FOOT

Fractures often result from trauma or direct injury to the bone. Stress fractures can also develop after repetitive activity, rather than a single injury. Fractures may either be non-displaced, where the bone is cracked but the ends of the bone are together, or displaced, where the end of the broken bones have partially or completely separated. Fractures can be closed fractures where the skin is not broken or open fractures where the skin is broken and the wound extends down to the bone, a serious condition because bacteria can enter the wound and cause infection in the bone.

The weight-bearing bones of the foot are especially vulnerable to stress fractures because of the repetitive forces they must absorb during activities like walking, running, and jumping.Stress fractures occur most often in the second and third metatarsals in the foot, which are thinner (and often longer) than the adjacent first metatarsal. This is the area of greatest impact on the foot when running or walking.Stress fractures are also common in the calcaneus (heel), talus (the small bone in the ankle joint); and the navicular (a bone on the top of the midfoot).

Symptoms

  • Pain that diminishes during rest
  • Pain that occurs and intensifies during normal, daily activities
  • Pain that worsens with weight-bearing activity
  • Swelling
  • Tenderness to touch at the site of the fracture
  • Possible bruising
  • Heal deformity (calcaneus fracture)

Diagnostic procedures

If symptoms suggest a foot fracture, seek qualified orthopedic medical treatment. Treatment will encompass a thorough examination, which could include diagnostic procedure(s) such as palpation, range of motion tests, X-rays, a CT scan, and an MRI in order to determine proper non-operative or operative treatment.

A bunion is a painful bony bump on the inside of the foot at the big toe joint. The big toe is made up of two joints. The largest of the two is the metatarsophalangeal joint (MTP). Bunions develop slowly at the MTP joint as the bones move out of alignment. Pressure on the big toe joint causes the big toe to lean toward the second toe and the normal structure of the bone changes, resulting in the bunion bump. This deformity will gradually increase and may make it painful to wear shoes or walk.Bringing the big toe back to its correct position could involve realigning bone, ligaments, tendons, and nerves.

Bunion surgery should only be considered when foot pain limits everyday activities, the big toe is chronically inflamed and swollen, the big toe is stiff and deformed, and other pain relief possibilities such as change in footwear and anti-inflammatory drugs have failed.

Symptoms

  • Visible bump on the inside of the foot
  • Pain and tenderness
  • Redness and inflammation
  • Hardened skin on the bottom of the foot
  • A callus or corn on the bump
  • Stiffness and restricted motion in the big toe
  • Difficulty walking

Diagnostic procedures

If symptoms suggest bunions, seek qualified orthopedic medical treatment. Treatment will encompass a thorough examination, which could include diagnostic procedure(s) such as X-rays in order to determine proper non-operative or operative treatment.

Diabetes is a condition of elevated blood sugar that affects about 6 percent of the population in the United States, or about 16 million people. Diabetic foot problems are a major health concern and are a common cause of hospitalization. Most foot problems that people with diabetes face arise from two serious complications of the disease: nerve damage and poor circulation. Nerve damage (neuropathy) is a complication of diabetes that leads to a loss of sensation in the feet. Some people with diabetes can no longer feel when something has irritated or even punctured the skin. Diabetes also damages blood vessels, decreasing the blood flow to the feet. Poor circulation weakens bone and can cause disintegration of the bones and joints in the foot. As a result, people with diabetes are at a high risk for breaking bones in the feet.

There are treatment options for the wide range of diabetic foot problems. The most effective treatment, however, is prevention. For people with diabetes, careful, daily inspection of the feet is essential to overall health and the prevention of damaging foot problems.

Symptoms

  • Swelling of the foot even without an obvious injury
  • Redness
  • Chronic foot sores
  • Deformity of the foot

Diagnostic procedures

If symptoms suggest a diabetic foot condition, seek qualified orthopedic medical treatment. Treatment will encompass a thorough examination, which could include diagnostic procedure(s) such as palpation, X-rays, a CT scan, an MRI, and a bone scan in order to determine proper non-operative or operative treatment.
Morton's neuroma is a persistent pain in the ball of the foot. A neuroma is a benign tumor of a nerve. However, Morton's neuroma is not actually a tumor, but a thickening of the tissue that surrounds the digital nerve leading to the toes, usually between the third and fourth toes in response to irritation, trauma or excessive pressure.The incidence of Morton's neuroma is 8 to 10 times greater in women than in men.

Symptoms

  • Burning pain in the ball of the foot that radiates into the toes
  • Intensified pain with activity
  • Numbness in the toes

Diagnostic procedures

If symptoms suggest Morton’s neuroma, seek qualified orthopedic medical treatment. Treatment will encompass a thorough examination, which could include diagnostic procedure(s) such as palpation, range of motion tests and X-rays in order to determine proper non-operative or operative treatment.
Plantar fasciitis is the most common cause of pain on the bottom of the heel. The plantar fascia is a long, thin ligament that lies directly beneath the skin on the bottom of the foot, supporting the foot arch and connecting the heel to the front of the foot. The plantar fascia is designed to absorb the high stresses and strains placed on feet, but sometimes too much pressure damages or tears the tissues. Plantar fasciitis occurs when the plantar fascia is irritated and inflamed. Approximately 2 million patients are treated for this condition every year.

Symptoms

  • Pain on the bottom of the foot near the heel
  • Pain with the first few steps after getting out of bed in the morning or after a long period of rest
  • Greater pain after exercise or activities

Diagnostic procedures

If symptoms suggest plantar fasciitis, seek qualified orthopedic medical treatment. Treatment will encompass a thorough examination, which could include diagnostic procedure(s) such as palpation, range of motion tests, X-rays, and an MRI in order to determine proper non-operative or operative treatment.

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