Common Disorders
Click on the categories below to read articles on foot disorders and conditions. You may also use the search button below.
Did you know the foot has 28 bones, 37 joints, 107 ligaments, 19 muscles, and numerous tendons? These parts all work together to allow the foot to move in a variety of ways while balancing your weight and propelling you forward or backward on even or uneven surfaces. It is no wonder that most Americans will experience a foot problem that will require the care of a specialist at one point or another in their lifetime.

Metatarsal fractures represent common injuries of the forefoot. The fifth metatarsal is the most common metatarsal to be fractured. Most commonly, it is injured during inversion type injuries (ankle sprains). Fractures to the fifth metatarsal may also occur from direct or crushing types of injuries, as well as from stress or fatigue fractures.

In general, fifth metatarsal fractures may be grouped into three basic types. The first is known as an avulsion fracture. This type of fracture is common with ankle sprains or other inversion type foot injuries. The fracture occurs at the base, or styloid process of the fifth metatarsal. It is caused by the traumatic pulling of the peroneal brevis tendon (or a ligament) from the end of the metatarsal. The fracture is always transverse in nature and usually results in very little displacement or malalignment. The second type of fracture is often referred to as aJones fracture. The fracture is also transverse in nature. However, it occurs further down on the metatarsal, in a region known as the metaphyseal-diaphyseal junction. This injury is usually caused by stress placed across the bone when the heel is off the ground and the forefoot is planted. This type of fracture my also represent an old stress fracture which has progressed to a complete fracture. This type of fracture is significant because it occurs in an area where the blood supply to the bone is less than adequate, causing healing problems. The final type of fracture is the spiral or oblique shaft fracture. This type of fracture is located closer to the fifth toe. It may be caused by either direct trauma or by mechanical stresses placed across the bone. This type of fracture pattern is very unstable resulting in a fracture, which is often displaced.

Deformities of the toes are common in the pediatric population. Generally they are congenital in nature with both or one of the parents having the same or similar condition. Many of these deformities are present at birth and can become worse with time. Rarely do children outgrow these deformities although rare instances of spontaneous resolution of some deformities have been reported.

Malformation of the toes in infancy and early childhood are rarely symptomatic. The complaints of parents are more cosmetic in nature. However, as the child matures these deformities progress from a flexible deformity to a rigid deformity and become progressively symptomatic. Many of these deformities are unresponsive to conservative treatment. Common digital deformities are underlapping toesoverlapping toesflexed or contracted toes and mallet toes. Quite often a prolonged course of digital splitting and exercises may be recommended but generally with minimal gain. As the deformity becomes more rigid surgery will most likely be required if correction of the deformity is the goal.

Activities such as football, basketball, soccer, field hockey and lacrosse show the high incidence of injury to the great toe joint on artificial surfaces. Other non-sporting causes include change in shoe gear, limited range of motion of the great toe joint, and sometimes flat foot conditions.

Mechanism of Injury

There are two mechanisms of injury for turf toe. The most common cause is hyperextension of the great toe joint. The great toe joint is hyper-extended as the heel is raised off the ground. An external force is placed on the great toe and the soft tissue structures that support the great toe on the top are torn or ruptured.

Physical Signs and Symptoms

Symptoms of acute injury include pain, tenderness and swelling of the great toe joint. Often there is a sudden acute onset of pain during push-off phase of running. Usually, the pain is not enough to keep the athlete from physical activities or finishing a game. This causes further injury to the great toe and will dramatically increase the healing time.

Hallux varus is a condition in which the great toe is pointing away from the 2nd toe. This can be considered the opposite of a hallux valgus or bunion deformity. In contrast to a bunion, however, the 1st metatarsal remains in its anatomical position while the great toe is deviated towards the middle of the body.

Hallux varus most commonly occurs as a complication from bunion surgery. However, other causes can lead to this condition. These include: congenital deformity, tight or short abductor hallucis tendon, trauma, absence or surgical removal of the fibular sesamoid.

The presenting symptom is most commonly pain. This can occur from the toe rubbing against the side of the shoe. Occasionally, this deformity can also lead to problems with ingrown nails as the nail fold is pushed into the nail border by the shoe.

Deformities of the toes are common in the pediatric population. Generally they are congenital in nature with both or one of the parents having the same or similar condition. Many of these deformities are present at birth and can become worse with time. Rarely do children outgrow these deformities although rare instances of spontaneous resolution of some deformities have been reported.

Malformation of the toes in infancy and early childhood are rarely symptomatic. The complaints of parents are more cosmetic in nature. However, as the child matures these deformities progress from a flexible deformity to a rigid deformity and become progressively symptomatic. Many of these deformities are unresponsive to conservative treatment. Common digital deformities are underlapping toesoverlapping toesflexed or contracted toes and mallet toes. Quite often a prolonged course of digital splitting and exercises may be recommended but generally with minimal gain. As the deformity becomes more rigid surgery will most likely be required if correction of the deformity is the goal.

Deformities of the toes are common in the pediatric population. Generally they are congenital in nature with both or one of the parents having the same or similar condition. Many of these deformities are present at birth and can become worse with time. Rarely do children outgrow these deformities although rare instances of spontaneous resolution of some deformities have been reported.

Malformation of the toes in infancy and early childhood are rarely symptomatic. The complaints of parents are more cosmetic in nature. However, as the child matures these deformities progress from a flexible deformity to a rigid deformity and become progressively symptomatic. Many of these deformities are unresponsive to conservative treatment. Common digital deformities are underlapping toesoverlapping toesflexed or contracted toes and mallet toes. Quite often a prolonged course of digital splitting and exercises may be recommended but generally with minimal gain. As the deformity becomes more rigid surgery will most likely be required if correction of the deformity is the goal.

Stiffness of the big toe joint is termed Hallux Limitus. Hallux is the medical term for the big toe. When the big toe possesses no motion, it is termed Hallux Rigidus. To confuse the topic, the big toe joint may appear to have normal motion, but this motion can be limited when weight is on the foot and during the normal gait cycle. This is termed functional Hallux limitus, because it occurs during the normal functioning of the foot while walking. As with many conditions that affect the foot, functional conditions progress to structural deformities. As the condition progresses, a degenerative type of arthritis develops in the big toe joint.

Diagnosis

The most common cause of Hallux limitus is an abnormal alignment of the long bone behind the big toe joint called the first metatarsal bone. In this condition, the first metatarsal bone is elevated relative to the other metatarsal bones that lie behind the other toes. When this is the case, the big toe joint cannot move smoothly and jamming occurs at the joint. A variety of symptoms can begin to occur. One common problem that occurs is pain in the bottom of the big toe where a central callous can develop. The pain and callous develop because the big toe does not bend upward enough as the bottom of the toe is jammed into the ground. People who have diabetes must watch this area carefully because the pressure can cause the development of an that can become infected.

The big toe, called the Hallux, is made up of two small bones called phalanges. This condition presents as a cocking up of the big toe at the joint between these two small bones. In the early stages of the condition the deformity is flexible, in later stages the deformity becomes rigid. It is caused by a variety conditions. Neurological diseases that cause muscle weakness or muscle imbalance in the muscles of the lower leg can result in the formation of Hallux hammertoe. This is commonly seen in patients after they have suffered a stroke or Cerebral Vascular Accident.Damage to certain areas of the brain during a stroke will frequently result in weakness and/or paralysis on one side of the body. If the stroke is not severe the patient may recover a majority of the function of the muscles in the legs and feet. However a residual result may be a cocking up of the big toe.

Other causes of the condition include damage or laceration to the tendon on the bottom of the big toe. Surgery to correct bunion deformities, in rare cases, may result in an imbalance of the structures about the big toe joint and cause the condition. An additional cause of hallux hammertoe is the absence of two small bones, called sesamoid bones, which are normally present beneath the big toe joint. There is an uncommon condition where a person may be born without these bones. More commonly however, the absence of one or both of the sesamoid bones is due to their surgical removal. In the course of correcting a bunion deformity one of the sesamoid bones may be removed. In another situation, a fracture of one or both of the sesamoid bones may result in the necessity to remove them to cure the pain associated with the injury (See the description of sesamoditis).