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Z Clin Med II - Ortho > Ankle and Foot > Flashcards

Ankle and Foot Flashcards

1
Q

At what joint does inversion and eversion occur?

A

Calcaneo-talar joint

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2
Q

Weber classifications of fibular fxs

A

Weber A: fibular fx below syndesmosis
Weber B: fibular fx at level of syndesmosis often tearing ligament
Weber C: fibular fx above syndesmosis, always tears ligament and disrupts mortise

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3
Q

MOI for calcaneal fx

A

Compression (ie. falling from a height)

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4
Q

MOI for talar fx

A

Foot hyper-plantarflexion

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5
Q

MOI for cuboid fx

A

Crush injury

Can be associated with navicular or cuneiform injuries

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6
Q

What is a Jones Fx

A

Fx of the diaphysis of 5th metatarsal

NOT an avulsion fx

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7
Q

Most common ankle sprain and the sequence in which lateral ligaments tear

A

Due to an inversion MOI, the anterior talo-fibular (ATF) sprains 90% of the time.
Tear in sequence from ATF to calcaneofibular (CF) and finally posterior talofibular (PTF)

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8
Q

Clinical signs of ankle sprain

A 
Pain, swelling
\+/- inability to bear weight
Foot may be inverted (talar tilt)
Passive inversion ROM will increase pain
Positive stress maneuvers (Drawer test and Inversion stress test)
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9
Q

Ottawa Ankle Rules

A

Xray only required if:

  • bony tenderness along distal 6 cm of tibia or fibula
  • bony tenderness at base of 5th metatarsal
  • inability to bear weight, both immediately after injury and in emergency department
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10
Q

3 degrees of ankle sprains

A

First degree: ligament stretching and local tenderness with minimal swelling
Second degree: severe stretching/partial tearing; more tenderness and swelling; abnormal stress tests
Third degree: Complete rupture, can’t bear weight

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11
Q

Management of ankle sprain

A

Ice, elevation, immobilization, consider crutches; third degree may need surgery

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12
Q

Clinical signs of ankle fx

A

Pain, swelling, bruising, inability to bear weight, significant deformity if dislocation is also present

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13
Q

Management of ankle fx

A

reduce fx/dislocation
immobilize, elevate
surgery
cast

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14
Q

Clinical signs and tx of calcaneal fx

A

swelling, pain, ecchymosis;

tx w/ surgery

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15
Q

Clinical signs and tx of talar fx

A

intense pain w/ inability to bear weight,
localized tenderness and swelling
may be misdiagnosed as ankle sprain
tx w/ ice, elevation, immobilization, surgery if displaced

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16
Q

Tx of 5th metatarsal fx

A

usually conservative (ice, rest, elevation)
immobilize
crutches

17
Q

MOI for 5th MT fx

A

inversion/avulsion of prox. bone by the peroneus brevis tendon

18
Q

Stress fxs of the forefoot (where they occur most, MOI, and diagnostic)

A

Most occur in the 2nd and 3rd MTs
MOI: excessive stress over time
Diagnostic procedures: xray (but may not show up for 2-3 weeks) or bone scan

19
Q

Complete Forefoot fxs (MOI and tx)

A

MOI: crush mechanism or twisting mechanism

Tx w/ ice, immobilization

20
Q

Phalangeal (toes) fxs (MOI, clinical signs, and tx)

A

MOI: direct trauma or hyper-extension
Signs: pain/swelling, deformity if dislocated
Tx: reduce, immobilize w/ buddy taping, stiff-soled shoes, if in great toe may require a walking cast

21
Q

Metatarsalgia definition and MOI

A

Nagging forefoot pain over middle metatarsal heads

MOI: d/t faulty weight distribution, gout, arthritis

22
Q

Morton’s neuroma definition

A

A neuropathy of interdigital nerve, usually proximal to bifurcation
Usually of the nerves supplying 2nd and 3rd toes
Usually occurs in middle age women

23
Q

Clinical signs of Morton’s neuroma and tx

A

Sudden attacks of sharp, burning pain radiating to toes
At first pain only occurs with walking, as injury progresses could have pain even at rest
Localized web space tenderness, reproduces pain
TX: initial: steroid/lidocaine injection
Definitive: surgery

24
Q

Hallux rigidus (definition, MOI, clinical, tx)

A

Stiffness of the MTP joint of the big toe
MOI: caused by arthritis, local trauma, gout, occurs more often in men
Clinical: pain w/ walking, tender MTP joint, pain w/ dorsiflexion
Tx: rocker soled shoes, NSAIDs, possibly surgery

25
Q

Hallux valgus (definition, tx)

A

Great toe angles inward (creates a bunion)
Occurs more often in females and often familial
Tx: conservative: wide, padded shoes
surgical: corrective osteotomy

26
Q

Hammertoe (definition, tx)

A

PIP joint fixed in flexion, DIP extended
most commonly affects second toe
Tx; operative joint excision

27
Q

Pes planus (definition, tx)

A

Due to collapsed medial arch (medial border of foot almost/does touch the ground when standing
May be congenital or acquired
usually don’t help small children, but older kids/adults use arch support or get surgical correction if there is an underlying cause

28
Q

Plantar fasciitis MOI

A

Usually an overuse injury in runners, standing occupations, rheum. arthritis and gout
Strain of fascial fibers, friction causes periostitis of calcaneus

29
Q

Plantar fasciitis Clinical signs and TX

A

Clinical: pain over plantar surface, increased with walking/running, relief w/ rest; tender palpation over calcaneus; pain w/ passive dorsiflexion
Tx: rest, NSAIDs, heel and arch support; steroid injection

30
Q

Post. tibial tendinitis MOI and tx

A

Overuse injury

Tx: rest, NSAIDs, possibly immobilize

31
Q

Peroneal tendinitis MOI and tx

A

Overuse injury

Tx: rest, NSAIDs, possibly immobilize

32
Q

Tarsal tunnel syndrome definition, clinical, tx

A

Entrapment of post. tibial nerve by flexor retinaculum usually caused by inflamm.
Clinical: numbness, pain of sole of foot
Tx: rest, NSAIDs, immobilize, possibly surgery

33
Q

Subluxing peroneal tendons MOI and tx

A

Occurs after injury that disrupts peroneal retinaculum; acute or chronic
Tendons sublux or actually dislocate over later malleolus
Tx; surgery

34
Q

Achilles tendonitis MOI, clinical, tx

A

MOI: overuse of calf muscles
Clinical: tenderness, increased pain w/ dorsiflexion
Tx: acute: rest, ice, NSAIDs, immobilize
chronic: may need surgery

35
Q

Achilles tendon rupture MOI

A

Usually d/t forced dorsiflexion of ankle (initiating sprint, slipping on stair)
Also may see with direct trauma (blow to taut tendon, laceration)
maybe partial or complete
occur often in middle age men

36
Q

Achilles tendon rupture clinical signs and tests

A

Signs: sudden pain, pt. may hear snap, difficulty stepping off, swelling in distal calf, palpable tendon defect, weak plantarflexion, MAY still be able to flex (d/t other muscles assisting)
Tests: + Thompson test

37
Q

What is Thompson test?

A

Sensitive for Achilles tendon rupture
Pt. lies prone with knee flexed to 90 degrees
Examiner squeezes the calf and the foot should plantarflex
If foot doesn’t plantarflex, + for Achilles tendon rupture

38
Q

Tx of Achilles tendon rupture

A 
Initially splint
Non weight bearing
refer to ortho
Conservative: casting for 8 weeks and PT
Surgery recommended for younger, athletic pts
39
Q

Hindfoot bursitis definition, MOI, tx

A 
inflammation of 2 bursae: 
-btw calcaneus and achilles tendon
-btw achilles tendon and skin
overuse injury usually d/t poor fitting shoes
Tx: rest, NSAIDs, proper fitting shoes

Z Clin Med II - Ortho (51 decks)

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