Common Foot Disorder - Assignment Example

Case Based Assignment Mr A. is diagnosed with a disorder called hallux abductovalgus. The patient experienced foot problems. In this case, a lot ofpossibilities are considered and looked upon why Mrs A experienced such abnormality in his feet. Upon having such an abnormality in the physiological structure of his body, the medical practitioner who is attending to the situation must look into the root cause and remedies why the said patient experienced such a problem. In order to fulfil the task, the medical practitioner must look into several procedures that must be followed in order to rectify this kind of disorder. The first thing that should be done is the identification of the said disorder. Yale S. (2007) described Hallux valgus referring to the lateral deviation of the first toe. The said disorder is associated with inflammation of the toe thus a person who experience this is expected to feel extreme pain. Furthermore, medicine.net (2006) pointed out that "big toe (the hallux) that is bent outward (valgus) so it overlaps the 2nd toe. A bunion is a localized painful swelling at the base of the big toe that can accompany hallux valgus. It is frequently associated with inflammation. It can be related to inflammation of the nearby bursa (bursitis) or degenerative joint disease (osteoarthritis)." Therefore, in order to prevent related complications, it is vital to know why the said disorder is present to Mrs A. To add to that, determining the treatment in line with the patient's capacity to withstand the process is vital in order to protect the health of the patient and to develop the favourable outcome with regards to the treatment process. It is anticipated that bones grow on toes of the patient which can be attributed to the immobility of the patient. Case Based Assignment 2 After determining the definition and the root cause of the problem, then diagnosis must follow. Here, the practitioner must take note vital steps and information that must be done in order to create and be able to determine the next step of treatment. Hallux Abductovalgus diagnosis is conducted by determining the history and physical exam of the patient including a lower extremity exam, subjective and objective findings with regards to their discrepancies, radiological evaluation and other diagnostic procedures (Guideline.gov 2006). In diagnosis, determining the history of the patient is vital to determine if such a condition is due to hereditary or driven by other factors. History may include general medical history, surgical, family and social history that may be vital in determining as to whether one of these aspects is the reason on why the patient is suffering such a condition. This kind of diagnosis would involve the geaealogy and lifestyle of Mrs A and relate it to his present condition. Also, in diagnosis, it is very important to consider that several medical examinations are vital to further determine the treatment of the disorder. "With a hallux abductovalgus deformity the great toe may or may not be deviated laterally. Hallux abductovalgus may be caused by biomechanical abnormalities that may lead to dysfunction in the first ray. There are numerous conditions associated with hallux abductovalgus, and sometimes it is necessary to treat these associated conditions while treating the hallux abductovalgus deformity (guidelines.gov 2006)" Therefore, if biochemical abnormalities are present it is vital to know the chemical set-up of the body of the patient particularly in the lower area and it is vital to have series of several medical examination that would track to origin of the abnormality. The aforementioned website also includes procedures such as "Radiological examination: X-rays must be taken. They may be used to Case Based Assignment 3 evaluate the type of deformity: soft tissue, osseous position deformity, structure deformity, joint destruction, sesamoid position. X-rays may be weight bearing, partial weight bearing, or non- weight bearing. Laboratory testing may be used to rule out inflammatory disease, degenerative joint disease, systemic illnesses, etc." After determining the origin and the kind of disorder, then the medical practitioner must now decide the kind of treatment that must be done in line with the physical and financial capability of the patient. Also, the kind of treatment would benefit the patient in a temporal or in a permanent basis. Therefore, the practitioner must make it clear with the patient that the outcome of the treatment process differs from one to the other depending on the scheme that the patient selects with the approval of the medical practitioner. In the treatment process, it is very important to know whether the treatment process is surgical or non surgical in nature. Of course, the treatment must be in accordance to the gravity of the need why the kind treatment must be done or to consider other alternatives. Surgical treatment refers to treatment which requires operation to correct the disorder. There are varieties of methods to conduct surgical procedure. These treatments include the likes of Partial removal of the medial side and/or dorsal aspect of the first metatarsal head. This is done with or without a soft tissue release. Also, Correcting the osseous deviation or subluxation of the joint. This may be performed with or without single or multiple astronomies, or may be done with a Keller procedure. Case Based Assignment 4 On the other hand, in case MR A declines surgical procedure either for health or economical reasons, the non-surgical procedure is the alternative. In this case, determining the kind of alternatives is vital. Also, if we are to deal with the root cause of this kind of this order Mrs A could have been using high heeled shoes as this kind of deformity traces its roots to such a condition. These compress the big toe and push it toward the second toe. The condition may become painful as extra bone and a fluid-filled sac grow at the base of the big toe. This leads to swelling and pain. Bunions occur more frequently in women and sometimes run in families. Before dealing with the kind of procedure that must be done, knowing the symptoms is also a hint as to or not to conduct surgical/non-surgical treatments. The website nbc4.tv (2006) pointed out these phenomenon and described the symptoms as follows Red, calloused skin along the foot at the base of the big toe A bony bump at this site Pain over the joint, aggravated by pressure from shoes Big toe turned toward the other toes If these symptoms are evident then the practitioner must also ask the complications that Mrs A feels in order to provide the accurate treatment of the disorder. The issues that must be settled may include the following: Foot deformity Stiff foot Hallux varus (occurs with surgical over-correction, where the toe points away from the second toe) Case Based Assignment 5 In order to further facilitate the treatment, it is better for the medical practitioner to select the best option that would benefit Mrs A. However, the practitioner must weigh the alternative options that would prevent treatment process if the case is not that much complicated. Simple prevention practice such as the use of wide toed shoes, preventing the toes from being fractured and being stressed could also be of big help in addressing problems such as these. However, if the deformity and disorder is still evident after such measures are done, then planning the treatment process now comes into place.If we are to refer with the first option of treatment which is the surgical, should the situation wont allow facilitating such things to happen, then it is also possible to consider non-surgical procedures. These procedures include the likes of :Padding the area with bunion pads;Injection of local anesthetic, anti-inflammatory injections, cortisones, oral anti-inflammatories ;Shoe modifications (i.e., wider shoes, molded shoes) ;Analgesics;Physical therapy ;Orthotic treatment are the procedures that must be followed. These procedures are deemed effective to cure the abnormalities and disorders concerning this kind of disease. However, the treatment would not end after the surgery or practicing the aforementioned non-surgical treatment. Also, suggesting alternatives to prevent and minimize the effect of this disorder is also important. "When a bunion first begins to develop, take good care of your feet and wear wide-toed shoes. This often solves the problem and prevents the need for any further treatment. It may help to wear felt or foam pads on the foot to protect the bunion, or devices to separate the first and second toes at night. These are available at drugstores. You can also try cutting a hole in a pair of old, comfortable shoes to wear around the house (K Fox.tv 2006)." Case Based Assignment 6 After being treated, the responsibility of the practitioner doesn't end there. There must be plans that have to be made in order to prevent such disorder from happening again in Mrs A's case. There are a lot of complicated tasks that the practitioner and Mrs A should follow. The maintenance scheme in order to protect the patient's feet. Also, the practitioner must monitor the progress and the some related problems during the post-treatment period. Such actions would further help Mrs A in the recovery and to avoid the disorder to happen again. Also, maintaining the feet as a stress free zone is the most effective cure for this disorder in the case of Mrs A due to the fact that "Passively applying a minimal amount of motion to the hallux causes significant discomfort with the patient non-weightbearing. Radiographs show an absence of joint space, with typical medial and lateral flaring of the joint interface, which is often described as "trumpeting" of the phalangeal base and metatarsal head. A dorsal exostosis is noted on the first metatarsal head. (Podiatry today 2003)" The only way to recover in this kind of disorder is through constant teamwork of both Mrs A and her podiatry. Reference: 1) Yale S. (2007), Common Foot Disorder. Clinical Medicine and Research 2) MedicineNet.com (2006), Defininition of Hallux Vargus. Opened 2007-03-03. URL available http://www.medterms.com/script/main/art.asparticlekey=6406 3) Guideline.gov (2006) Hallux Vargus. Opened 2007-03-03 URL available http://www.guideline.gov/summary/summary.aspxview_id=1&doc_id=4240#s23 4) . Shereff MJ, Bejjani FJ, Kummer FJ 9(1986.): Kinematics of the first metatarsophalangeal joint. J Bone S Surg Am 68:392, 5) . Vanore IV, Corey SV (.1992) Hallux limitus, rigidus, and metatarso-phalangeal joint arthrosis. In: Marcinko DE, ed. Comprehensive Textbook of Hallux Abducto Rigidus Reconstruction. St. Louis: Mosby Year Book; chap 10. 6) Banks AS, McGlamry ED (1992): Hallux limitus and rigidus. Pp. 600-616. In McGlamry ED (ed). Comprehensive textbook of foot surgery 2nd edition. Williams and Wilkins, Baltimore, MD,. 7) nbc4.tv (2006) Bunions. Opened 2007-03-03 URL available http://www.nbc4.tv/encyclopedia/6861718/detail.html Supporting References Wu KK. Morton's (2006) gital neuroma: a clinical review of its etiology, treatment, and results. J Foot Ankle Surg ;35:112-119; discussion 187-188. [PubMed]. 2. Ferrari J, Higgins JP, Prior TD (2004) Interventions for treating hallux valgus (abductovalgus) and bunions. Cochrane Database Syst Rev. :CD000964. [PubMed]. 3. Torkki M, Malmivaara A, Seitsalo S, Hoikka V, Laippala P, Paavolainen P (2001). Surgery vs orthosis vs watchful waiting for hallux valgus: a randomized controlled trial. JAMA. ;285:2474-2480 Read More