Glossary

Arch - The arch of the foot is the area of the bottom of the foot between the heel pad and toe pad.

Acrokeratosis verruciformis - a hereditary dermatosis characterized by the presence of numerous flat wart-like papules on the dorsal aspect of the hand, foot, elbow, and knee.

Ankle - the part of the leg just above the foot; the joint between the leg and the foot. It is a hinge joint formed by the junction of the tibia and fibula with the talus, or ankle bone. The bones are cushioned by cartilage and connected by a number of ligaments, tendons, and muscles that strengthen the joint and enable it to be moved. Because it is in almost constant use, the ankle is particularly susceptible to injuries, such as sprain and fracture. It is also often one of the first joints to be affected by arthritis or gout.

Ankle clonus - a series of abnormal reflex movements of the foot, induced by sudden dorsiflexion, causing alternate contraction and relaxation of the triceps surae muscle.

Athlete's foot - a fungal infection of the skin of the foot; called also tinea pedis. It causes itching and often blisters and cracks, usually between the toes. Causative agents are Candida albicans, Epidermophyton floccosum, and species of Trichophyton, which thrive on warmth and dampness. If not arrested, it can cause a rash and itching in other parts of the body as well. It is likely to be recurrent, since the fungus survives under the toenails and reappears when conditions are favorable. Although Athlete''s foot is usually little more than an uncomfortable nuisance, its open sores provide excellent sites for more serious infections. Early treatment and health care supervision insure correct diagnosis and prevention of complications. Specific diagnosis is made by microscopic examination or culture of skin scrapings for the fungus.

Patients who undergo surgery to correct arthritis in the foot are often diabetics with a type of arthritis known as Charcot Foot. The average age of patients developing a Charcot foot is 40 years. About one-third of patients develop a Charcot foot in both feet and/or ankles. This form of arthritis can develop suddenly and without pain. Quite suddenly, the bones in the foot and/or ankle can spontaneously fracture and fragment, often causing a severe deformity.

The arch of the foot often collapses, and pressure areas develop on the bottom of the foot, leading to open sores or ulcers.

While many of these deformities can be treated with nonsurgical care, surgery may be required. Such instances may include:

  • Chronic deformity with increased plantar pressures and risk of ulcers.
  • Chronic deformity with significant instability that cannot be corrected by braces.
  • Significant deformity that may include ulcers that don't heal or respond to therapy.

Surgical procedures used to treat arthritis include:

  • Hindfoot and ankle realignment. This kind of procedure is usually prescribed when there is significant instability resulting in a patient being unable to walk. Various types of internal fixation are placed within the foot during this kind of procedures.
  • Midfoot realignment. This kind of procedure is usually prescribed when there is significant instability of the middle portion of the foot. During a midfoot realignment, various types of internal fixation are placed within the foot.
  • Ostectomy. In this procedure, a portion of bone is removed from the bottom of the foot. It is usually performed for a wound on the bottom of the foot that is secondary to pressure from a bony prominence.



Sterling and Gaston