Case 13 Polio Foot
Case
13
Polio
Foot
What Happened ? When
and How it Happened ?
Introduction
ownself
Exposure
– Upto Umbilicus
Hand
scrubbing
Look- Standing
Patient
Comment on
Footwears / Calipers –Below knee
Attitude of the
limb
Alignment - Front
Both shoulders and Pelvis are leveled,
No wasting of Quadriceps muscles
Patella facing forward and at equal
height
Leg
–Genu vlagum , foot and toes look normal with normal
overlying skin or clawing of toes
Wasting of Muscles on anterolateral muscle
compartment (Anterior +
Peronei group of muscles )
Side Elbows straight overlying greater trochanter
Knee
flexed or Straight , Foot Equinus deformity
Foot Cavus deformity
Back
Spinal
curvature is maintained with no kyphoscoliosis
Normal overlying skin on back with no
dimpling , tuft of hair
and swelling
Calf
symmetrical with normal overlying skin
Heel
has – Normal varus or Valgus or Excess Varus deformity
Gait Equinus /Normal / trendelenburg
Squating heel
at the same level
Check Lumbar region before lying down
the patients
Lie
down Patient
After lying down
check plantar surface of the feet.
Feel
Temperature
Superficial
Palpation – leg , ankle , hindfoot, forefoot
Deep Palpation – tibia, Medial Malleolus ,
Calcaneum,First Metatarsal , Phalanges , other Metatarsals , Navicle , Lateral
Malleolus, Fibula
Movement
Plantarflexion
/ Dorsiflexion – cup the heel during measurement
Inversion
/ Eversion- lock talus
LLD
Measure
Foot Size –
Medial
Side Medial Malleolus to Heel Tip
Medial Malleolus to
Ist MT Head
Lateral
Side Lateral Malleolus – Heel Tip
Lateral Mallolus to 5th
MT head
Ligamentous
Stability – MCL
LCL
Neurovascular
Assessment
Sensory
Examination Dorsum , Ist Web Space , Plantar Surface
of Feet - intact in Polio
Motor
Examination
Power
of the Muscles – TA
/ EHL /EDC ;
TP/ Gastrosoleus /
FHL;
Peronei
Also check power of
Hamstrings ,
Reflexes
Special
Tests –
Trendelenburg
Ober’s Test
Vascular
Examination – DPA / PTA
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