Primary Foot Care Primary Foot Care. Common Nail Problems.

80
Primary Foot Care

Transcript of Primary Foot Care Primary Foot Care. Common Nail Problems.

Page 1: Primary Foot Care Primary Foot Care. Common Nail Problems.

PrimaryFoot CarePrimary

Foot Care

Page 2: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 3: Primary Foot Care Primary Foot Care. Common Nail Problems.

Common Nail ProblemsCommon Nail Problems

Page 4: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 5: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 6: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 7: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 8: Primary Foot Care Primary Foot Care. Common Nail Problems.

When toRefer?

When toRefer?

Page 9: Primary Foot Care Primary Foot Care. Common Nail Problems.

Fungal NailsFungal Nails

Page 10: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 11: Primary Foot Care Primary Foot Care. Common Nail Problems.

Fungal Nails - Treatment

• Routine Debridement

• Topical Agents

• Oral Agents

• Routine Debridement

• Topical Agents

• Oral Agents

Page 12: Primary Foot Care Primary Foot Care. Common Nail Problems.

Oral AgentsOral Agents• Fluconazole (Diflucan)

• Itraconazole (Sporanox)

• Ketoconazole (Nizoral)

• Griseofulvin (Gris-peg)

• Terbinafine (Lamisil)

• Fluconazole (Diflucan)

• Itraconazole (Sporanox)

• Ketoconazole (Nizoral)

• Griseofulvin (Gris-peg)

• Terbinafine (Lamisil)

Fungal Nails - TreatmentFungal Nails - Treatment

Page 13: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 14: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 15: Primary Foot Care Primary Foot Care. Common Nail Problems.

When toRefer?

When toRefer?

Page 16: Primary Foot Care Primary Foot Care. Common Nail Problems.

Pedal Skin ProblemsPedal Skin Problems

• Tinea Pedis

• Verrucae

• Corns & Callouses

• Tinea Pedis

• Verrucae

• Corns & Callouses

Page 17: Primary Foot Care Primary Foot Care. Common Nail Problems.

Tinea PedisTinea Pedis

Page 18: Primary Foot Care Primary Foot Care. Common Nail Problems.

Tinea Pedis - Etiology

• Dermatophytes– Trichophyton

– Epidermophyton

– Microsporum

• Saprophytes and Yeast

• Bacteria

Page 19: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 20: Primary Foot Care Primary Foot Care. Common Nail Problems.

Tinea Pedis - Treatment• Topical Agents

– Imidazoles: miconazole, clotrimazole, sulconazole, etc.

– Others: undecylenic acid, tolnaftate

• Oral Agents– Used in severe/resistant cases– Griseofulvin, ketoconazole– Fluconazole, itraconazole, terbinafine

• Local Care

Page 21: Primary Foot Care Primary Foot Care. Common Nail Problems.

When toRefer?

When toRefer?

Page 22: Primary Foot Care Primary Foot Care. Common Nail Problems.

VerrucaeVerrucae

Page 23: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 24: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 25: Primary Foot Care Primary Foot Care. Common Nail Problems.

When toRefer?

When toRefer?

Page 26: Primary Foot Care Primary Foot Care. Common Nail Problems.

Corns & CallousesCorns & Callouses

Page 27: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 28: Primary Foot Care Primary Foot Care. Common Nail Problems.

Corns - When to Refer?Corns - When to Refer?

• Multiple Lesions

• Multiple Digital Deformities as Cause

• Rigid Digital Contractures

• Ulcerative Lesion– Immediate– Definitive

• Diabetics, PVD, Neuropathic

• Multiple Lesions

• Multiple Digital Deformities as Cause

• Rigid Digital Contractures

• Ulcerative Lesion– Immediate– Definitive

• Diabetics, PVD, Neuropathic

Page 29: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 30: Primary Foot Care Primary Foot Care. Common Nail Problems.

Morton’s Neuroma - EtiologyMorton’s Neuroma - Etiology• Narrow Shoes (Primary Cause)• High Heels• Biomechanical (Functional) Abnormalities

– Excessive pronation– Flatfoot– Hammertoes

• Traumatic • Anatomic

• Narrow Shoes (Primary Cause)• High Heels• Biomechanical (Functional) Abnormalities

– Excessive pronation– Flatfoot– Hammertoes

• Traumatic • Anatomic

Page 31: Primary Foot Care Primary Foot Care. Common Nail Problems.

Interosseous TendonsInterosseous Tendons

IntermetatarsalSpace

IntermetatarsalSpace

Dorsal DigitalNerves

Dorsal DigitalNerves

Morton’sNeuromaMorton’sNeuroma Deep Transverse

IntermetatarsalLigament

Deep TransverseIntermetatarsalLigament

Plantar DigitalNervesPlantar DigitalNerves

Flexor DigitorumLongus TendonFlexor DigitorumLongus Tendon

Page 32: Primary Foot Care Primary Foot Care. Common Nail Problems.

Morton’s Neuroma - Symptoms• Burning

• Tingling

• Numbness (Usually only Subjective)

• Radiating Pain into the Involved Toes

• Feeling as Though “Walking on a Pea” or “Sock is Bunched Up”

• Strong Desire to Stop, Remove Shoe, and Massage Forefoot

• Burning

• Tingling

• Numbness (Usually only Subjective)

• Radiating Pain into the Involved Toes

• Feeling as Though “Walking on a Pea” or “Sock is Bunched Up”

• Strong Desire to Stop, Remove Shoe, and Massage Forefoot

Page 33: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 34: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 35: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 36: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 37: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 38: Primary Foot Care Primary Foot Care. Common Nail Problems.

When toRefer?

When toRefer?

Page 39: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 40: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 41: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 42: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 43: Primary Foot Care Primary Foot Care. Common Nail Problems.

Hammertoes -Conservative TreatmentHammertoes -Conservative Treatment• Treat Only the Symptoms

• Aperature Pads

• Splints

• Extra-depth Shoes

• Caution When Using Acid Plasters In:– Diabetics– PVD– Neuropathic

• Treat Only the Symptoms

• Aperature Pads

• Splints

• Extra-depth Shoes

• Caution When Using Acid Plasters In:– Diabetics– PVD– Neuropathic

Page 44: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 45: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 46: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 47: Primary Foot Care Primary Foot Care. Common Nail Problems.

Pre-OpPre-Op

Post-OpPost-Op

Page 48: Primary Foot Care Primary Foot Care. Common Nail Problems.

Pre-OpPre-Op

Post-OpPost-Op

Page 49: Primary Foot Care Primary Foot Care. Common Nail Problems.

Hammertoes - When to Refer?Hammertoes - When to Refer?

• Rigid Deformities

• Recurrent Ulceration

• Chronic Pain in All Types of Shoes

• Other Associated/Contributing Deformities

• Patient No Longer Satisfied with Conservative Therapy

• Rigid Deformities

• Recurrent Ulceration

• Chronic Pain in All Types of Shoes

• Other Associated/Contributing Deformities

• Patient No Longer Satisfied with Conservative Therapy

Page 50: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 51: Primary Foot Care Primary Foot Care. Common Nail Problems.

190

Page 52: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 53: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 54: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 55: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 56: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 57: Primary Foot Care Primary Foot Care. Common Nail Problems.

When toRefer?

When toRefer?

Page 58: Primary Foot Care Primary Foot Care. Common Nail Problems.

Heel PainHeel Pain

Page 59: Primary Foot Care Primary Foot Care. Common Nail Problems.

Heel Pain - EtiologyHeel Pain - Etiology

• Plantar Fasciitis/Heel Spur Syndrome

• Heel Bursitis

• Nerve Entrapment

• Stress Fracture

• Systemic Arthritides

• Biomechanical

• Obesity

• Plantar Fasciitis/Heel Spur Syndrome

• Heel Bursitis

• Nerve Entrapment

• Stress Fracture

• Systemic Arthritides

• Biomechanical

• Obesity

Page 60: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 61: Primary Foot Care Primary Foot Care. Common Nail Problems.

Heel Spur Syndrome/Plantar FasciitisHeel Spur Syndrome/Plantar Fasciitis

• Rest Strap• OTC Arch Support• Custom Orthotic• NSAIDs• Injections - Cortisone• Stretching Exercises• Physical Therapy

• Rest Strap• OTC Arch Support• Custom Orthotic• NSAIDs• Injections - Cortisone• Stretching Exercises• Physical Therapy

Conservative TreatmentConservative Treatment

Page 62: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 63: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 64: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 65: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 66: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 67: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 68: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 69: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 70: Primary Foot Care Primary Foot Care. Common Nail Problems.

FlatfootFlatfoot

Page 71: Primary Foot Care Primary Foot Care. Common Nail Problems.

When toRefer?

When toRefer?

Page 72: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 73: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 74: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 75: Primary Foot Care Primary Foot Care. Common Nail Problems.

Flatfoot - Why Treat?

• Bunion Deformity

• Hammer Digit Syndrome

• Metatarsalgia

• Chronic Plantar Fasciitis/HSS

• Postural Pains in Legs, Knees, Back

• Arthritis of Involved Joints (AJ,STJ,MTJ)

• Bunion Deformity

• Hammer Digit Syndrome

• Metatarsalgia

• Chronic Plantar Fasciitis/HSS

• Postural Pains in Legs, Knees, Back

• Arthritis of Involved Joints (AJ,STJ,MTJ)

Conditions Associated with Untreated Flatfoot:

Page 76: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 77: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 78: Primary Foot Care Primary Foot Care. Common Nail Problems.
Page 79: Primary Foot Care Primary Foot Care. Common Nail Problems.

When toRefer?

When toRefer?

Page 80: Primary Foot Care Primary Foot Care. Common Nail Problems.

ConclusionConclusion