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Ankle and Foot Disorders Guideline

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Ankle and Foot Disorders Guideline Ankle and Foot Disorders Effective Date: July 16, 2018 Contributors to Ankle and Foot Disorders Guideline Editor-in-Chief: Kurt T. Hegmann, MD, MPH, FACOEM, FACP Assistant Editor: Matthew A. Hughes, MD, MPH Evidence-based Practice Ankle and Foot Panel Chair: Nelson S. Haas, MD, MPH, FACOEM Evidence-based Practice Ankle and Foot Panel Members: Patrick J. Beecher, MD, MPH, MBA, FACOEM Mark Easley, MD Hannah Edwards, MD, MPH Harold Hoffman, MD, FRCPC Steven Mandel, MD, FACOEM RobRoy L. Martin, PhD, PT, CSCS Pete Thomas, DPM, QME The Evidence-based Practice Ankle/Foot Panel represents expertise in occupational medicine, neurology, podiatric surgery, foot and ankle surgery, physical therapy, and rehabilitation science. Guidelines Methodology Consultant: Kurt T. Hegmann, MD, MPH, FACOEM, FACP Research Conducted By: Kurt T. Hegmann, MD, MPH, FACOEM, FACP Matthew A. Hughes, MD, MPH Jeremy J. Biggs, MD, MSPH Matthew S. Thiese, PhD, MSPH Ulrike Ott, PhD, MSPH Kristine Hegmann, MSPH, CIC Atim Effiong, MPH Holly Diane Uphold Emilee Eden, MPH Jenna K. Lindsey, BS Copyright © 2008-2018 by Reed Group, Ltd. All rights reserved. Commercial use prohibited. Licenses may be purchased from Reed Group, Ltd. at https://www.mdguidelines.com/. Specialty Society and Society Representative Listing: ACOEM acknowledges the following organizations and their representatives who served as reviewers of the “Ankle and Foot Disorders” guideline. Their contributions are greatly appreciated. By listing the following individuals or organizations, it does not infer that these individuals or organizations support or endorse the ankle and foot treatment guidelines developed by ACOEM. Copyright ©2020 Reed Group, Ltd. Page | 1 2011 EXTERNAL REVIEWERS American Physical Therapy Association Stephanie Albin, DPT, FAAOMPT, OCS Thomas G. McPoil, PT, PhD, ATC, FAPTA American Podiatric Medical Association Clinical Practice Advisory Committee (CPAC) California Orthopaedic Association Carol Frey, MD Other Reviewers: Kathryn L. Mueller, MD, MPH, FACOEM 2015 EXTERNAL REVIEWERS American Academy of Physical Medicine & Rehabilitation American Association of Occupational Health Nurses Kimberly Olszewski, DNP, CRNP, COHNS-CM, FAAOHN American College of Foot and Ankle Surgeons Andrew J. Meyr, DPM, FACFAS American Occupational Therapy Association Michelle L. Bradshaw, DC, OTR/L Julie Dorsey, OTD, OTR/L, CEAS American Physical Therapy Association American Podiatric Medical Association James R. Christina, DPM American Society of Anesthesiologists Andres Navedo, MD California Orthopedic Association Eric Gokcen, MD F. Ray Nickel, MD, MPH Tye Ouzounian, MD Steven Ross, MD Ronald Smith, MD Copyright ©2020 Reed Group, Ltd. Page | 2 Table of Contents Impact ................................................................................................................................................................................................................... 7 Summary of Recommendations and Evidence ................................................................................................................................... 7 Basic Principles and Definitions ................................................................................................................................................................ 8 Initial Assessment ............................................................................................................................................................................................ 9 Table 1. Red Flags for Potentially Serious Ankle and Foot Conditions ......................................................................................................... 9 Medical History and Physical Examination ....................................................................................................................................... 10 Medical history ....................................................................................................................................................................................................................... 10 Physical Examination .......................................................................................................................................................................................................... 12 Diagnostic Criteria ........................................................................................................................................................................................ 14 Table 2. Diagnostic Criteria for Non-red-flag Conditions that Can Be Managed by Primary Care Physicians ......................... 15 Work-Relatedness ........................................................................................................................................................................................ 16 Work Activities .............................................................................................................................................................................................. 16 Initial Care ........................................................................................................................................................................................................ 16 Follow-up Visits ............................................................................................................................................................................................. 16 Maximal Medical Improvement .............................................................................................................................................................. 17 Special Studies and Diagnostic and Treatment Considerations ............................................................................................... 17 Achilles Tendinopathy ................................................................................................................................................................................ 17 General Approach and Basic Principles...................................................................................................................................................................... 17 Initial Assessment ................................................................................................................................................................................................................. 18 Medical History ...................................................................................................................................................................................................................... 18 Physical Examination .......................................................................................................................................................................................................... 18 Work Restrictions ................................................................................................................................................................................................................. 18 Special Studies, Diagnostic and Treatment Considerations ............................................................................................................................. 18 Achilles Tendon Rupture ........................................................................................................................................................................... 40 General Approach and Basic Principles...................................................................................................................................................................... 40 Work-Relatedness ................................................................................................................................................................................................................. 40 Initial Assessment ................................................................................................................................................................................................................. 41 Diagnostic Criteria ................................................................................................................................................................................................................ 41 Workplace Intervention ..................................................................................................................................................................................................... 41 Special Studies, Diagnostic and Treatment Considerations ............................................................................................................................. 41 Ankle Tendinopathies (Other than Achilles Tendinopathy) ..................................................................................................... 54 Tenosynovitis (Including Stenosing Tenosynovitis) ..................................................................................................................... 54 General Approach and Basic Principles...................................................................................................................................................................... 54 Initial Assessment ................................................................................................................................................................................................................
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