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Primary Foot Care. Common Nail Problems. When to Refer?. Fungal Nails. Fungal Nails - Treatment. Routine Debridement Topical Agents Oral Agents. Oral Agents. Fungal Nails - Treatment. Fluconazole (Diflucan) Itraconazole (Sporanox) Ketoconazole (Nizoral) Griseofulvin (Gris-peg)

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Presentation Transcript
slide1
Primary

Foot Care

slide8
When to

Refer?

fungal nails treatment
Fungal Nails - Treatment
  • Routine Debridement
  • Topical Agents
  • Oral Agents
oral agents
Oral Agents

Fungal Nails - Treatment

  • Fluconazole (Diflucan)
  • Itraconazole (Sporanox)
  • Ketoconazole (Nizoral)
  • Griseofulvin (Gris-peg)
  • Terbinafine (Lamisil)
slide15
When to

Refer?

pedal skin problems
Pedal Skin Problems
  • Tinea Pedis
  • Verrucae
  • Corns & Callouses
tinea pedis etiology
Tinea Pedis - Etiology
  • Dermatophytes
    • Trichophyton
    • Epidermophyton
    • Microsporum
  • Saprophytes and Yeast
  • Bacteria
tinea pedis treatment
Tinea Pedis - Treatment
  • Topical Agents
    • Imidazoles: miconazole, clotrimazole, sulconazole, etc.
    • Others: undecylenic acid, tolnaftate
  • Oral Agents
    • Used in severe/resistant cases
    • Griseofulvin, ketoconazole
    • Fluconazole, itraconazole, terbinafine
  • Local Care
slide21
When to

Refer?

slide25
When to

Refer?

corns when to refer
Corns - When to Refer?
  • Multiple Lesions
  • Multiple Digital Deformities as Cause
  • Rigid Digital Contractures
  • Ulcerative Lesion
    • Immediate
    • Definitive
  • Diabetics, PVD, Neuropathic
morton s neuroma etiology
Morton’s Neuroma - Etiology
  • Narrow Shoes (Primary Cause)
  • High Heels
  • Biomechanical (Functional) Abnormalities
    • Excessive pronation
    • Flatfoot
    • Hammertoes
  • Traumatic
  • Anatomic
slide31
Dorsal Digital

Nerves

Intermetatarsal

Space

Interosseous

Tendons

Flexor Digitorum

Longus Tendon

Morton’s

Neuroma

Plantar Digital

Nerves

Deep Transverse

Intermetatarsal

Ligament

morton s neuroma symptoms
Morton’s Neuroma - Symptoms
  • Burning
  • Tingling
  • Numbness (Usually only Subjective)
  • Radiating Pain into the Involved Toes
  • Feeling as Though “Walking on a Pea” or “Sock is Bunched Up”
  • Strong Desire to Stop, Remove Shoe, and Massage Forefoot
slide38
When to

Refer?

hammertoes conservative treatment
Hammertoes -Conservative Treatment
  • Treat Only the Symptoms
  • Aperature Pads
  • Splints
  • Extra-depth Shoes
  • Caution When Using Acid Plasters In:
    • Diabetics
    • PVD
    • Neuropathic
slide47
Pre-Op

Post-Op

slide48
Pre-Op

Post-Op

hammertoes when to refer
Hammertoes - When to Refer?
  • Rigid Deformities
  • Recurrent Ulceration
  • Chronic Pain in All Types of Shoes
  • Other Associated/Contributing Deformities
  • Patient No Longer Satisfied with Conservative Therapy
slide57
When to

Refer?

heel pain etiology
Heel Pain - Etiology
  • Plantar Fasciitis/Heel Spur Syndrome
  • Heel Bursitis
  • Nerve Entrapment
  • Stress Fracture
  • Systemic Arthritides
  • Biomechanical
  • Obesity
heel spur syndrome plantar fasciitis
Heel Spur Syndrome/Plantar Fasciitis
  • Rest Strap
  • OTC Arch Support
  • Custom Orthotic
  • NSAIDs
  • Injections - Cortisone
  • Stretching Exercises
  • Physical Therapy

Conservative Treatment

slide71
When to

Refer?

flatfoot why treat
Flatfoot - Why Treat?

Conditions Associated with Untreated Flatfoot:

  • Bunion Deformity
  • Hammer Digit Syndrome
  • Metatarsalgia
  • Chronic Plantar Fasciitis/HSS
  • Postural Pains in Legs, Knees, Back
  • Arthritis of Involved Joints (AJ,STJ,MTJ)
slide79
When to

Refer?

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