ORTHOPEDIC NURSING

COMMON FOOT PROBLEMS

Common Foot Problems
• Plantar fasciitis
• Hammer toe
• Hallux valgus (Bunion)
• Claw foot: pes cavus
• Morton’s neuroma
• Flatfoot: pes planus

PLANTAR FASCITIS
Inflammation of the foot-supporting fascia
• Heel pain experienced with first steps in the
morning. CORN
Overgrowth of horny layer of epidermis between the toes
and is produced by:
• Internal pressure- underlying bone is prominent
due to congenital/acquired abnormality-
commonly arthritis
• External pressure – ill fitting shoes 5th toe-
commonly involved
Cause
• Fat pad on the heel becomes thinner - ↓shock
absorption (walking)
• X-rays - provide clear images of bones - fractures or
arthritis.

Treatment : Podiatrist (foot doctor)

• Soaking and scrapping the horny layer
• Application of a protective pad
• Dry and separate the toes with gauze
• Wider shoe will be helpful
• Surgery

CALLUS
• Thickened area of the skin→ persistent pressure or
friction
Treatment • Painful
• Rest • Keratolytic ointment applied and thin plastic cup
• Ice - Rolling the foot over a cold water bottle or ice worn over the heel if the callus is on this area
for 20 minutes 3 to 4 times a day. • Surgery : Excision
• NSAIDs
• Exercise (plantar fascia/calf stretch) INGROWN TOE NAIL
• Shoes with thick soles and extra cushioning can
• Trimming the nails properly-
reduce pain with standing and walking
clipping them straight across
• Night splint - stretches the plantar fascia.
• Washing the foot 2x/day,
• Corticosteroid injection - ↓ inflammation
antibiotic ointment
• Plantar fascia release- (surgery) the plantar fascia
• Surgery: Removal of ingrown
ligament is partially cut to relieve tension in the
toe nail
tissue

DMC
 ORTHOPEDIC NURSING
COMMON FOOT PROBLEMS
HAMMER TOE Treatment :
Flexion deformity of the interphalangeal joint. ⮚ Wear shoes that conforms to
Acquired deformity the shape of the foot
- Tight socks/shoes may push an overlying toe back ⮚ Corticosteroid injections
into the line of other toes.

Treatment :
▪ Wearing open
toed sandals or
shoes that
conform to the Post op:
shape of the foot 1. Pain management – opiod analgesia(morphine)
▪ Manipulative 2. Foot elevated to the level of the heart to decrease
exercises edema and pain.
▪ Protect the 3. Toe flexion and extension exercises- to facilitate
protruding joints walking
with pad 4. Well fitting shoes - recommended
▪ Surgery:
Osteotomy PES CAVUS
• Clawfoot- foot with abnormally high arch and fixed
HALLUX VALGUS equinus deformity of the forefoot.
• Bunion- deformity in
which the great toe
deviates laterally
• S/S - Osseous
enlargement (exostosis) of
the medial side of the first
metatarsal head,over
which a bursa may form

Treatment:
1. Exercises to
manipulate the
forefoot into
dorsiflexion and relax
the toes.
2. Arthrodesis(Fusion)-
to reshape and stabilized the foot.

MORTON’S NEUROMA
• Plantar digital
neuroma- swelling of
Contributing Factors: the 3rd(lateral) branch
⮚ Heredity of the median plantar
⮚ Ill fitting shoes nerve.
⮚ Gradual lengthening and widening of the foot • S/S- throbbing burning
associated with aging pain in the foot that is
usually relieved by rest.

DMC
 ORTHOPEDIC NURSING
COMMON FOOT PROBLEMS
Treatment:
• Insert inner soles and metatarsal pads designed to
spread the metatarsal heads and balance the foot
posture.
• Local injections of corticoseroids
• Surgery: Neurectomy

FLAT FOOT
• Pes planus-longitudinal arch of the foot is
diminished

Cause:
• Congenital anomaly
• Bone ligament injury
• Muscle and poor imbalances
• Excessive weight
• Muscle fatigue
• Poorly fitting shoes
• Arthritis

S/S
• Burning sensation
• Fatigue
• Clumsy gait
• Edema
• Pain

Treatment: Exercise to strenghten the muscles and to

improve the posture and walking habits are helpful.

DMC