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Sports Injuries of the Ankle and Foot presents both surgical and non-surgical protocols for the treatment of both simple and complex sports-related injuries of the foot and ankle. This comprehensive, one-source reference is divided into anatomical sections: the forefoot, the midfoot, the hindfoot, the ankle, tendon disorders, and orthotics and braces - each enhanced by rehabilitation procedures and algorithms. This easy-to-use format enables the physician to formulate a treatment plan and compare the various surgical and non-surgical options for a variety of injuries including: stress and other fractures, ankle instability, ruptures, sprain, ligament injuries, tendonitis, lesions, and neuropathies. As more internists and family physicians increase the scope of their practices to include sports medicine, this book reaches beyond the orthopaedic surgery market and will become a widely referred to source for the treatment of these common injuries.

Inhoudsopgave

Voorwerk

1. Ankle

Abstract
Tears of the lateral ankle ligaments are among the most common sports injuries (Jackson et al., 1974). The spectrum of injury ranges from mild sprains, after which an athlete might return to activity the same day, to frank rupture of one or more ligaments, which can cause considerable lost time from sport and persistent symptoms. Furthermore, chronic lateral instability occurs in nearly 20% of patients (Boruta et al., 1990; Freeman, 1965; Freeman et al., 1965; Kannus and Renstrom, 1991; Rijke et al., 1988).
Richard A. Marder, George J. Lian

2. Hindfoot

Abstract
The heel refers to the calcaneus and the tissues that attach to and surround it. There are a variety of acute and chronic conditions and injuries in this anatomic region that commonly occur in athletes and have the potential to impair performance. These entities can usually be diagnosed by a direct history combined with careful examination. Knowledge of the anatomy of the heel and the pathologies usually involved, together with the history, guide the physical examination. For the purposes of diagnosis and treatment, it is useful to classify heel pain anatomically into posterior and subcalcaneal heel pain.
Richard A. Marder, George J. Lian

3. Midfoot

Abstract
The spectrum of injury to the tarsometatarsal joints ranges from a mild sprain to frank dislocation. Dislocation of the tarsometatarsal joints is recognized as a significant injury, but lesser degrees of injury are often overlooked. Nonetheless, these “milder” injuries are often associated with prolonged symptoms and disability in the athlete.
Richard A. Marder, George J. Lian

4. Forefoot

Abstract
The great toe and its metatarsophalangeal (MTP) joint are affected by numerous injuries, that in turn affect athletic performance. During the last phase of stance in the gait cycle, the body’s weight is transferred forward onto the ball of the foot and the toes. From heel rise to toe-off during barefoot gait, the first MTP joint dorsiflexes with the joint subjected to a force 0.8 times body weight (McBride et al., 1991). Progressively decreasing forces are measured at the second through fifth MTP joints. First MTP joint forces are increased severalfold during athletic activities that involve running and jumping. The crouched position of a baseball catcher and the en pointe position of a ballet dancer are examples of high stress that occurs at the first MTP joint during athletics (Teitz et al., 1985). Such stress can lead to both acute and chronic injuries of the great toe.
Richard A. Marder, George J. Lian

5. Tendon Disorders

Abstract
Achilles tendonitis is a common overuse problem found in a variety of athletes. Its incidence has been noted to be as high as 18% in a group of runners (Krissoff and Ferris, 1979). Any athlete who is involved in repetitive impact loading from running or jumping is at risk for developing Achilles tendonitis (Clain and Baxter, 1992).
Richard A. Marder, George J. Lian

6. Nerve Injuries

Abstract
One of the most common causes of forefoot pain is irritation of an interdigital nerve termed Morton’s neuroma. The typical symptoms were first described in 1876 by Thomas Morton, and in 1940 Betts identified a neuroma as the cause of this pain. The syndrome has classically referred to neurogenic pain in the ball of the foot centered between the third and fourth toes.
Richard A. Marder, George J. Lian

7. Skin and Nails

Abstract
The skin is the largest organ of the body. Enclosing the other tissues it acts as a protective barrier that maintains a stable internal chemical environment. The plantar skin of the foot, as well, provides protection from the high pressures of weight-bearing. Skin blocks the invasion of infectious organisms. Constriction and dilation of blood vessels in the skin and the sweat mechanism are important factors in the regulation of body temperature. The skin provides a large sensory interface with the external world through which varied information is input to the brain, including temperature, pressure, pain, pleasure, and position.
Richard A. Marder, George J. Lian

8. Orthotics, Bracing, and Taping

Abstract
Athletic shoewear has two basic functions. The first, fundamental requirement is that it must protect the foot. The second is to act as an interface between the body and the functional surface. Highly specialized footwear has developed for most sports that provides these two functions. Consider the contrast between a ski boot and a ballerina’s slipper, each of which has evolved to optimize athletic performance.
Richard A. Marder, George J. Lian

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