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  • Book
    Douglas H. Richie, Jr.
    Summary: This new book consolidates the current knowledge of lower extremity biomechanics and pathomechanics and makes this information relevant to the study of common foot and ankle pathologies. The content is presented in a language and format that allows the clinician to review current evidence explaining the etiology of these disorders in order to formulate effective treatment interventions. In order to understand pathomechanics, the clinician must also become versed in the normal, healthy biomechanics of the lower extremity. A review of gait, muscle function and forces acting on the lower extremities during physical activity will be the focus of the first part of this book. The second part of the book will study the common, challenging pathologies treated on a daily basis by foot and ankle clinicians: hallux abducto valgus, hallux rigidus, metatarsalgia, digital deformities, adult acquired flatfoot, and plantar heel pain. These chapters discuss all the relevant factors contributing to these conditions, evaluating and exposing myths and misconceptions about the pathomechanics and treatments of these conditions. For each disorder, a comprehensive review of published research provides a foundation for an updated, valid description of etiology and risk factors. Providing a fresh approach to lower extremity pathomechanics and management strategies, Pathomechanics of Common Foot Disorders is a valuable resource for podiatrists and orthopedic foot and ankle surgeons at all levels. .

    1: Comparative Anatomy and Introduction to the Twisted Plate Mechanism
    The Specialization of the Human Foot
    Ontogeny of the Human Foot
    Does Ontogeny Recapitulate Phylogeny of the Human Foot?
    Ankle and Hindfoot Development: Twisting the Plate of Bones
    Ontogeny of the Forefoot
    Rotation of Segments
    The Twisted Plate Provides the Specialized Function of the Human Foot
    Clinical Application of the Twisted Plate Mechanism
    Twisting the Plate and Locking for Optimal Foot Function High-Gear Push Off
    What Initiates High-Gear Push Off?
    Testing the Theory of High-Gear Push Off
    What Is the Ideal Alignment of the Human Foot?
    The Myth of Midfoot "Locking"
    What Stiffens the Human Foot?
    The Springlike Function of the Human Foot
    2: Human Walking: The Gait Cycle
    Key Events in the Walking Gait Cycle
    Phase 1 Initial Contact 0- 2% of the Gait Cycle (Fig. 2.3)
    Phase 2 Loading Response 2-12% of the Gait Cycle (Fig. 2.4)
    Phase 3 Midstance 12- 31% of the Gait Cycle (Fig. 2.5) Phase 4 Terminal Stance 31-50% of the Gait Cycle (Fig. 2.6)
    Phase 5 Pre-swing 50-62% of the Gait Cycle
    Phase 6 Initial Swing 62-75% of the Gait Cycle Events (Fig. 2.8)
    Phase 7 Mid-swing 75-87% of the Gait Cycle (Fig. 2.9)
    Phase 8 Terminal Swing 87-100% of the Gait Cycle (Fig. 2.10)
    Common Compensatory Changes Observed in Gait
    3: Motion of the Foot: Joints, Muscles, and Sensorimotor Control
    General Motion of the Foot Segments
    The Bone Pin Studies
    The Lateral Metatarsals Move More than the Medial The Navicular-Cuneiform Joints Move More than the Midtarsal Joint
    The Midfoot Joints Contribute More Sagittal Plane Motion than the Ankle
    The Medial Column Moves More than the Ankle
    Pure Ankle Joint Motion Can Now Be Measured
    The Ankle Moves in the Transverse and Frontal Planes
    There Is more Frontal Plane Motion in the Ankle than the Subtalar Joint
    The Talonavicular Joint and the Calcaneocuboid Joints Move More than the Subtalar Joint
    Majority of First Ray Motion Is as the Naviculocuneiform Joint
    The Lateral Metatarsals Move More than the Medial Metatarsals The Lateral and Medial Columns Have the Same Sagittal Plane Motion
    How Does the "Normal" Foot Function in Gait?
    Neuromuscular Control
    Do Joint Axes Determine Direction and Range of Motion?
    Muscle Function in the Lower Extremity
    Phasic Activity
    Muscle Strength
    Moment Arm
    Major Muscle Contributors in Six Planes of Motion (Summary of Table 3.2)
    Sagittal Plane
    Frontal Plane
    Transverse Plane
    Muscle Activity/Demand and Foot Type
    The Plantar Intrinsic Muscles
    Storage and Return of Energy
    Twisting the Plate Stores and Releases Energy
    Digital Access Springer 2021