Pedorthic Management Exam Questions
with Detailed Solutions
Metatarsalgia - --Generic term for pain in the forefoot/ball from repetitive
stress, associated with a drop or collapse of the metatarsal arch causing the
soft tissue to be pinched or trapped between the bones
-Metatarsalgia treatment - --reduce and redistribute forefoot pressure,
reduce painful joint motion, and correct any forefoot malalignment
-Metatarsalgia foot orthotic - --Total contact to transfer forefoot pressure
into the longitudinal and metatarsal arches
-Post adjacent metatarsals heads as necessary
-Shock absorbent materials under metatarsal heads and toes
-Metatarsalgia shoewear - --Lower heel to reduce forefoot and metatarsal
head pressure
-Utilize shock absorbent soling
-Utilize longer and wider shoe to reduce medial-lateral circumference
pressures
-Metatarsalgia shoe modification - -Rocker bottom sole to reduce forefoot
motion and pressures
-metatarsal bar to shoe to shift pressure proximally
-negative heel modification
-excavation under painful metatarsal
-Morton's Interdigital Neuroma - -Perineural fibrosis- type of nerve
compression syndrome which involves the common digital nerves of the
lesser toes (often 3rd, 2nd)
-reduce forefoot pressure, reduce metatarsal compression to relieve
interdigital nerve entrapment and limit friction or shear inside of shoe
-Morton's Interdigital Neuroma foot orthotic - --total contact orthosis with a
metatarsal pad to transfer pressure to the longitudinal and metatarsal arches
-shock absorbent material under metatarsal heads (viscoelastic polymers or
silicones)
-Morton's Interdigital Neuroma shoewear - --utilize longer or wider shoe to
reduce ML and circumferential or radial pressures
-lower heel to reduce metatarsal head pressure
-long medial counter to support long arch
, -Morton's Interdigital Neuroma shoe modifications - --Rocker sole to shoe to
reduce FF motion and pressures
-Carefully placed metatarsal pad to elevate and separate metatarsals
-Metatarsal bar to shift pressures proximally
-Morton's Toe - -Congenital short first met, a hypermobile first met, and
calluses under the 2nd and 3rd met.
-reduce forefoot pressure, reduce 2nd MTPJ pressure, and limit friction or
shear inside of shoe
-Morton's Toe foot orthotics - --total contact with a metatarsal pad and 1st
toe extension to transfer pressure to the longitudinal and metatarsal arches
-shock absorbent material under metatarsal heads
-Morton's Toe shoewear - --shock attenuating vibram sole to reduce plantar
pressures
-lower heel to reduce metatarsal head pressure
-long medial counter to support long arch
-Morton's Toe shoe modification - --rocker sole to shoe to reduce FF motion
and pressures
- carefully placed met pad to elevate and separate mets
-met bar to shift pressures proximally
-Hallux Valgus "Bunion" - -Hallux abducto valgus is an enlargement of bone
and/or soft tissue around the joint at the base of the first MTPJ associated
with abnormal rotation of the great toe and abnormal drifting or inward
leaning of the great toe towards the 2nd toe and adduction of the met
-reduce pressure and friction to the first MTPJ and hallux
-improve forefoot pressure distribution
-reduce profanatory forces
-correct any malalignment
-Hallux Valgus Bunion foot orthotic - --total contact with a met pad to
transfer forefoot pressures into longitudinal and metatarsal arches
-shock absorbent materials under met heads and toes
-Hallux Valgus Bunion shoewear - --bunion last to accommodate foot shape
-deep and wide toe box (oblique) with soft leather (deerskin) uppers to
reduce pressure
-utilize longer and wider shoes to reduce ML circumferential pressures
-utilize shock absorbent soling
-thermal moldable shoe
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