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.

Adult-acquired flatfoot or posterior tibial tendon dysfunction usually leads to a gradual loss of the arch. The posterior tibial muscle is a deep muscle in the back of the calf and has a long tendon that extends from above the ankle and attaches into several sites around the arch of the foot. The muscle acts like a stirrup on the inside of the foot to help support the arch. The posterior tibial muscle stabilizes the arch and creates a rigid platform for walking and running. If the posterior tibial tendon becomes damaged or tears, the arch loses its stability and as a result, collapses, causing a flatfoot.

Surgery is often performed to give the patient a more functional and stable foot. Several procedures may be required to correct a flatfoot deformity, depending on the severity of the problem. These may include:

  • Tenosynovectomy—a procedure to clean away (debridement) and remove any of the inflamed tissue around the tendon.
  • Osteotomy—removal of a portion of the heel bone (calcaneus) to move the foot structure back into alignment.
  • Tendon Transfer—in which replacement fibers from another tendon are inserted to help repair damage.
  • Lateral Column Lengthening—A procedure that implants a small piece of bone, usually removed from the hip, outside of the heel bone to create the proper bone alignment and rebuild the arch.
  • Arthrodesis—Fusing of one or more bones together to eliminate any joint movement, which stabilizes the foot and prevents any further deterioration or damage.



Sterling and Gaston